Sunday, December 21, 1997

Texans to pay for home health care cuts

By Anita Bradberry

Very little attention has been focused on the massive cuts to home health care under Medicare made by Congress last summer when it passed the Balanced Budget Act of 1997, but thousands of Texas families are about to feel the devastating effects.

Beginning in February 1998, 25,000-40,000 elderly Texans will lose their current home health services. As 1998 progresses, many thousands more elderly persons and their families may find that they cannot get the home health services they need.

More than $16 billion in home health services will be deleted from projected Medicare expenditures over the next five years.

The absence of these home health services will sorely burden Texas' state budget because many of these elderly will use Medicaid -- the state/federal medical program for the poor -- to meet the demands of their chronic illnesses.

This spells disaster, for Texas at least. Our state has more elderly people living below the poverty level than any state in the nation. As far as Texas is concerned, it appears that Congress has passed the buck from the federal government to state government.

The dozens of changes in Medicare embodied in the Balanced Budget Act of 1997 add up to the demise of desperately needed home care services under Medicare.

The result is that the federal government is shedding responsibility for those elderly patients who need sustained home care services in order to continue living in their own homes independently.

That is really the saddest part of this scenario -- the effect it will have on elderly Texans who have thus far been able to retain their pride and independence with the help of home care. Many of them will be forced into nursing homes to get their needed care, or they will bounce in and out of hospitals as their diabetic, cardiac or other conditions begin to destabilize.

This care is much more expensive when administered in a hospital or nursing home than through home care services, and the patients find it much less desirable.

By far the most troubling aspect of the situation is the fact that we -- Texas taxpayers -- are going to pay dearly for these changes.

We will pay for them not only through additional state taxes for Medicaid, but also through the pain of watching our loved ones lose their dignity and their independence.

Anita Bradberry is executive director of the Texas Association for Home Care, a nonprofit trade association that promotes quality and economic viability of licensed agency providers of home and community support services in Texas.