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Obamacare cuts home healthcare for millions of seniors

By Dan Weber

Friday, February 28, 2014

President Obama’s mendacious political promise, “If you like your health care plan, you can keep it,” continues to cast a long and disturbing shadow of doubt and confusion over millions of Americans who have lost coverage as a result of Obamacare. As 2014 unfolds, the most vulnerable senior citizens — those who receive home health care services — are about to learn they are out of luck. Obamacare opens a trap door under them, leaving this elderly population in freefall — with many citizens losing access to home health care.

Add another compelling reason to reverse Obamacare. Whether by accident or intention, the “Affordable Care Act” empirically strips America’s oldest and poorest cohort, all part of the World War II generation, of this basic coverage. Here is how.

On Jan. 1, Medicare’s home health care services, formerly serving 3.5 million elderly beneficiaries across the country, were cut under Obamacare. The cut deleted exactly 14 percent, or an estimated $22 billion, from these lowest-income Americans over four years. News of the forthcoming cut only trickled out the Friday before Thanksgiving, yet another stunning attempt by the Obama White House to reduce Medicare benefits without attracting notice.

Guess what? We noticed. This cut does irreparable damage to recipients of Medicare’s home health care services, those who are aged, homebound and sicker than the average Medicare population. Indeed, nearly two-thirds of Medicare home health care users live at or below the federal poverty level, meaning they are the most economically compromised of America’s precious senior citizens.

This cut is an indictment of White House policies. Home health care agencies have always provided services to homebound Medicare beneficiaries. No hoopla, but when these Americans needed skilled care, they got it. In contrast to expensive hospital care, critical health care services got into millions of American homes via clinicians. Home health care was — and still is — vital. It is also now effectively gone for these Americans.

How did home health care save money for taxpayers? Using 2009 as a reference year, Medicare’s average Part A and Part B payment for a home health care visit was $145, compared to $373 per day in a skilled nursing facility or a whopping $1,805 per day in a hospital. In addition, according to one leading expert, skilled home health care services saved the Medicare program $2.8 billion during the most recent three-year period. Approximately $670 million of that savings is attributable to 20,000 fewer hospital readmissions.

Given these facts, one would conclude that the value of home health care in driving down Medicare costs should be obvious, if this — and not a single-payer system — were the real goal of Obamacare. How did we lose sight of common sense? Just keep patients in a familiar surrounding — their homes, not in an expensive hospital — keep sound disease management programs that deliver better and more cost-effective outcomes, and continue to coordinate care for patients. That was working. Now we have the reverse — markedly higher medical and insurance costs, with absolutely no institutional connection, support or continuing benefits for these especially needy Americans, the ones who depended — with their families — on critical home health care benefits. The president and his Democratic surrogates in the House and Senate have done it again: They have wiped out another critical, working system with this Obamacare monstrosity.

What else will this home health care cut achieve? It will hit the small businesses that provide home health care nationwide, and is already doing so. More than 90 percent of those providing home health care are small businesses. According to the U.S. Center for Medicare and Medicaid Services, 40 percent of these companies will be operating “at a loss” — that is, they will likely fold or end up in bankruptcy — by 2017 as a result of the cut. What does that mean? It means nearly 5,000 more Medicare home health care providers may go out of business, and nearly 500,000 more jobs within this flogged industry may be wiped out to fund Obamacare. Those who care about such things should put that into their future unemployment calculations — and then thank Mr. Obama and his congressional friends, who all got a waiver and probably do not worry about home health care anyway.

Attacking our weakest senior citizens is no way to run a country. It is, in a word, reprehensible. This abomination devastates another existing and essential Medicare promise, while throwing one more gut-wrenching punch at this job sector. Does the truth no longer matter? Do these lives no longer matter? Do these businesses and jobs no longer matter? When will Mr. Obama and his allies in Congress let up and allow Americans to look after themselves again, as we used to quite well?

Read more:

2 Concerning misinformation on obamacare on Mon Mar 24, 2014 9:00 pm


And I would quote this to rebutt S.S.C.: (from

Obamacare  doesn't replace Medicare. Medicare isn't part of your State's health insurance marketplace (sometimes called an exchange), so if you have Medicare keep it. You will still get all the new benefits, rights and protections ObamaCare offers on your current Medicare plan. If you have retiree insurance, aren't old enough for Medicare and don't like it you may choose to use the marketplace to replace that insurance. Find out more about
retiree insurance and Medigap insurance.

Even though ObamaCare "cuts" Medicare; it isn't really a cut, it's health care reform aimed at improving care for seniors. The fact is, millions more seniors will be covered under Obama's health care plan. Here are some things that the program does to improve Medicare:
• ObamaCare closes the "donut hole" that was causing Seniors not to be able to afford their prescriptions. (The Medicare "donut hole" is the Part D drug coverage limit where seniors must start paying out of pocket for their prescriptions.) In 2012, seniors got a 50 percent discount when buying brand name drugs and 14 percent discount on generic drugs covered by Medicare Part D. This reform gets stronger every year, increasing coverage and closing the donut hole until it disappears in 2020. From that point on, seniors will only pay usual drug co-pays.
• ObamaCare expands existing coverage for seniors, including preventive care and wellness visits without charging you for the Part B co-insurance or deductible. Seniors will no longer need to put off preventive care and check-ups due to costs. This reform has been active since 2011 and gives seniors better access to cancer screenings, wellness visits, personalized prevention plans, vaccines, flue shots and more.
• New initiatives to support care coordination, your doctor may get additional resources to make sure that your treatments are consistent.
• ObamaCare does not cut any benefits from Medicare Advantage.



Attention Seniors – Obamacare Forcing 14 % Cut to Medicare’s Home Health Care

Posted 12/14/2013 |

seniors obamacarefrom The Washington Examiner – by Richard Pollock -

“An estimated 3.5 million poor and ill homebound senior citizens will wake up on New Year’s Day to discover Obamacare has slashed funding for their home health care program.

It will happen because the Centers for Medicare and Medicaid Services quietly issued a regulation Nov. 22 announcing a 14-percent cut over the next four years in funding for the Home Health Care Prospective Payment program.

The rule cuts Medicare payments to home health care providers by 3.5 percent each year beginning in 2014, for a total cut of 14 percent.

The program puts health care in the homes of seniors suffering from acute or chronic afflictions, or who are in need of rehabilitation therapy.

By CMS’s own calculation, 40 percent or nearly 5,000 home health companies — mainly small businesses — will experience a “net loss” in revenue due to the cuts and go into the red by 2017. That will put many of them out of business.

The National Association for Home Care and Hospice calculates the losses will be much more severe, affecting 75 percent of all home health care companies.

Nearly a half million skilled home care workers are also projected to lose their jobs over the next four years due to the cuts, according to the program’s supporters.”

The cuts may also have a disproportionate impact on minorities and those living in under-served rural communities.

A November 2013 study by Avalere Health, a Washington, D.C., health care business analysis firm, found that two out of three home health care recipients fall at or below the federal poverty line.

The study also estimated that one in four seniors getting home health care are age 85 or older.

Federal officials had discretion to keep Medicare home payments at the same level or impose a maximum 3.5 percent cut each year through 2017 to reach the 14-percent reduction.

But CMS opted to impose the maximum reduction, beginning on New Year’s Day 2014.

Former U.S. Rep. Billy Tauzin decried the rule, saying “it’s obviously a decision they’ve made to maximize reductions in Medicare spending in order to fund Obamacare.”

The Affordable Care Act that President Obama signed into law in 2010 included $716 billion in Medicare cuts to help fund Obamacare.

“They’ve just basically doubled down and said, ‘We’re going to cut seniors’ health care again, and we’re going to cut the most vulnerable of all in America in order to fund the ACA,’” Tauzin, a Republican, said.

Tauzin said the cuts did not have to be made: “This was an extra cut. It was a discretionary authority of CMS to review the base funding for home health.”

Tauzin is now a political consultant to the Partnership for Quality Home Healthcare, a trade group that represents 12 home health care companies.

Tracey Moorhead, president and CEO of the Visiting Nurses Associations of America, called the cuts “devastating.”

Moorhead said in a Dec. 2 blog post that “the home health industry was not included in the models envisioned by [Obamacare], other than as a revenue raiser for the legislation.”

Val J. Halamandaris, president of the National Association for Home Care & Hospice, said Congress asked CMS to evaluate the home health care benefit to increase access and efficiency and to reduce costs, not to kill the program.

“Instead, all they did was look to impose the largest possible cut — 3.5 percent a year — on the Medicare home health benefit,” he said.

Moorhead said the decision to cut the program was made before completion of a study — for the government — of how the reductions would affect vulnerable patients.

“So it is unclear to us how they have effectively and appropriately considered the impact on vulnerable patients,” she said, “before they have put out this final rule.”

Fifty-one senators appealed in a September letter to Tavenner to reject the proposed cuts to home health care agencies, saying enactment “would raise serious concerns about access to care for vulnerable seniors.”

There were 35 Democratic signers of the letter to Tavenner, 15 Republicans and one independent.

Also in September, 142 members of the House of Representatives wrote Tavenner that “home health is a critical service that allows patients to be treated in a cost effective manner in the environment they prefer — their home.”

Sixty-six House Democrats joined 76 House Republicans in signing that letter.

Twenty-six organizations representing a broad coalition of health care and social service organizations also called upon House and Senate leaders last August to oppose the proposed cuts.

“If finalized in its current form, this rule will put access to care at risk in rural, minority and underserved communities all across the U.S.,” the coalition members said.

Defending the rule, CMS Principal Deputy Administrator Jonathan Blum said, “CMS is confident that Medicare beneficiaries will continue to receive quality home health services across the country under our final policies.”


I am on medicare and nothing has changed, except it is better with the affordable care act, my medicines on some I pay only a dollar, and the more expensive ones I pay 20 dollars maxium


I also received home health care for two weeks,after surgery four weeks ago,at no cost to me..this is a good plan~


I'm sure there are going to be many stories of pros and cons about Obamacare in the beginning, but as the total program is implemented and is rewritten hundreds of more times to please one group or another the end results may not be so sparkling. They have 6 more days to get the goal enrollment or it will become a financial bust, with the shortfall coming as more cuts, taxes and limitations on services. The you can keep your Dr. spew from Obama was a crock, many people are finding their Drs are not in the network and are being forced to search for new ones same with hospitals and certain procedures are now being denied. If it works for you great, but the millions who's insurance was cancelled because of Obamacare it doesn't seem to be working for. Obama's claim you could keep your old insurance ( the one cancelled) also turned out to be another false statement on his part he couldn't bully the insurance companies into reinstating those policies. Time will tell if this will be his shining moment or his total demise in his presidency.


I also have humana which has passed all regulations under the AFC ,I got to keep my doctors or whatever doctors I want. the Affordable care act is a success, after a slow start 5million have signed up so far. under Gov,Beshear the Medicare in our state has been expanded, that is why Ky. was one of the first successful states under the AFC


The WH is saying 5 million they need at least 7 million in Sibelius own words she has no idea how many have signed up nor does that figure represent the ones who actually paid after they signed up. They are spending millions on the most ridicules commercials, surely just that money alone could have been put to better use. Like I said time will tell.


yes it will improve with time! now,it is doing a good thing for millions of citizens,and will get better with time. at least a bill was produced,more than I can say for the ones repealing the law 50
+times on our tax dollars. I am experiencing a hands on, because It is working for me, and many other seniors.


[quote="gypsy"]yes it will improve with time! now,it is doing a good thing for millions of citizens,and will get better with time. at least a bill was produced,more than I can say for the ones  repealing the law 50
+times on our tax dollars. I am experiencing a hands on, because It is working for me, and many othMedicaid expansion kicks off, but Louisiana residents being left out: Editorial

Louisiana Gov. Bobby Jindal rejected the Medicaid expansion that is part of the Affordable Care Act. (File photo)
The Editorial Board, | The Times-Picayune By The Editorial Board, | The Times-Picayune
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on January 01, 2014 at 6:58 AM, updated January 01, 2014 at 11:19 AM
As of Jan. 1, hundreds of thousands of low-income Americans who lacked health insurance are newly eligible for Medicaid. Twenty-five states and the District of Columbia agreed to take part in the expansion of the federal health care program for the poor under the Affordable Care Act. Not Louisiana.

So the more than 242,000 uninsured Louisiana residents who likely could benefit from the new coverage aren't getting a chance to do so. That is a shame.

Those families won't get the relief that having health coverage could bring. They will still have to worry about whether they can afford to see a doctor - and may delay getting care until they have to go to an emergency room. That is a difficult way to live and is not a route to good health.

It is not smart for the state, either. The federal government is paying 100 percent of the cost of the expansion for the first three years. A new study by WalletHub found that Louisiana will lose out on $2.58 in funding for each $1 in federal taxes that state residents will pay for the expansion in other states. The study also ranked Louisiana third -- with $2,091.14 -- in savings residents would get from reduced out-of-pocket expenses if Gov. Jindal approved the Medicaid expansion.

A previous study by the Commonwealth Fund showed that Louisiana will lose out on $1.65 billion in federal dollars in 2022 alone. The federal government will be paying 90 percent of the cost of the Medicaid expansion that year. If the state agreed to the expansion, its share of the cost for that year would be $280 million.

Gov. Jindal has said that Louisiana can't afford even that amount of matching money. But the Commonwealth Fund study pointed out that the state's share for Medicaid would be a small fraction of the $2.2 billion Louisiana is projected to spend on incentives to attract private business in 2022.

"No state that declines to expand the program is going to be fiscally better off" because of that decision, said Sherry Glied, one of the authors of the report.

The sting for Louisianians is that their federal taxes will help pay for uninsured residents in other states to take advantage of the health coverage. Not only that, but the state will lose out on new jobs.

An estimated 15,600 new jobs in health care and other fields are predicted for Louisiana if the state accepts the money, according to a study by Families USA and the Louisiana Consumer Healthcare Coalition. That would have a major impact on our economy.

Overall, Louisiana would get almost $16 billion in new health care dollars under the expansion.

Expanding Medicaid is most important, of course, because it is the best way to provide health care coverage to tens of thousands of poor Louisianians who lack insurance. These are people who earn too much money for Medicaid under the old formula but can't afford to buy a policy and aren't covered at their jobs. Many of them also don't qualify for other provisions of the Affordable Care Act. The Kaiser Family Foundation says there are 242,150 Louisiana residents in those circumstances.

Gov. Jindal has remained stubbornly opposed to the Medicaid expansion, despite the benefits to Louisiana residents and to the state's economy.

Other conservative governors realized the expansion would good for their states, even though they opposed President Obama's Affordable Care Act. Ohio Gov. John Kasich, Michigan Gov. Rick Snyder and Pennsylvania Gov. Tom Corbett -- all Republicans - are taking the Medicaid money.

At least 1.5 million Americans in those and other states have enrolled in Medicaid or the federal Children's Health Insurance Program since Oct. 1, according to a recent report from the Centers for Medicare and Medicaid Services.

Even though the expansion goes into effect today, Louisiana can still opt in. At this point, the state would have to wait several months to get the new benefits, but it would be the smart thing to do.

It also would be the humane thing to do. Leaving thousands of uninsured Louisianians in the lurch when it would be so easy to help them is unconscionable.


gypsy wrote:I also have humana which has passed all regulations under the AFC ,I got to keep my doctors or whatever doctors I want. the Affordable care act is a success, after a slow start 5million have signed up so far. under Gov,Beshear the Medicare in our state has been expanded, that is why Ky. was one of the first successful states under the AFC

Kentucky economy to grow cautiously, experts say

By Cheryl Truman
February 11, 2014

Kentucky's economic outlook is for cautious and measured growth over the next year — nearly identical to projections for the nation at large — according to the Center for Business and Economic Research at the University of Kentucky.

Chris Bollinger, a UK economics professor and economic research center director, said he expects gross domestic growth of 2 percent in Kentucky for 2014, with an unemployment rate of 6.5 percent, employment growth of 1.5 percent and manufacturing employment growth of 0.6 percent.

He made the remarks Tuesday during a speech at the annual state economic outlook seminar at the Lexington Convention Center.

National projections call for gross domestic product growth of 2.5 percent, an unemployment rate of 6.5 percent, employment growth of 2 percent and manufacturing employment growth of 0.5 percent.

"Kentucky actually did pretty well right away coming out of the recession," Bollinger told the audience of about 300 Lexington-area business leaders. "Lexington's had a couple of bad years here, but I think we are starting to turn back up."

However, Don Mullineaux, UK's DuPont endowed chair in banking and financial services, stated in a 30-year summary of his work at UK that forecasts are difficult to nail. "We don't know how to predict recessions," he said.

Mullineaux plans to retire from UK later this year.

Bollinger said Kentucky's economic strengths are a diverse industry mix and low operations costs. He said the state's weakness is low educational attainment, particularly at the bachelor's-degree level, where Kentucky lags in the number of science and technology graduates.

Lt. Gov. Jerry Abramson addressed the group to promote Gov. Steve Beshear's tax plan. "Literally every Kentuckian will benefit from the rate-change proposal," he said.

Abramson also championed the proposal to tax services, which would include everything from warranty contracts to downloaded software. Without the tax changes, Abramson said, Kentucky cannot afford to fully fund its education system.

He said having Kentucky offer legal gambling is another key to education funding.

Without both components, he said, "we will not have the kind of educated and competitive workforce Kentucky needs."

In response to an audience question, Abramson said Kentucky has too many counties and separate county governments. The Bluegrass State has 120 counties, the third-most in the nation after Texas and Georgia, states that are much larger in area. ("You can tell I'm not running for governor," he said after his statement.)

Decreasing the number of counties would create efficiencies, he said, but it would be politically and socially difficult.

The Kentucky annual economic report cited several tidbits about the state's economy: Foreign company employment in Kentucky is about 6 percent; the U.S. average is 5 percent. The Kentucky disability income rate is 8.2 percent; the national rate is 4.7 percent.

Read more here:


In response to Alma, there is a catch 22 that in a few years the state was to be held responsible for all the health care bills which is why not only La. but other states are bowing out until they stop writing and rewriting this train wreck. As many are finding out what coverage you have this week may not be there next week. There seems to be big issues showing up in cancer coverage, pacemakers, hip replacement surgery and a host of other procedures. Obama with his pen and phone has the vision he can throw an executive order out there and get his way. This foolishness is being stopped in its tracks. If this is such a great deal for medical coverage why are unions, and our politicians including Obama exempt from being forced to buy the coverage ???


Note: If you have arrived at this article in response to the news of April 25, 2013 regarding Congress discussing exempting themselves from Obamacare, note that this is a much older article. You can read my article on today’s news by clicking on this link.

Sean Hannity at King of Prussia Mall, PA
Image via Wikipedia

Of all the many gripes and complaints directed my way when it comes to the Affordable Care Act, the one that appears to tick people off the most is a widespread belief that Congress has carved out some exemptions for themselves that provide our elected representatives with cushy health insurance benefits while the rest of us are left to experience diminishing coverage from employers or, come 2014, enter the unknown world of state run health insurance exchanges.

I certainly understand why people believe that this injustice is taking place right under their noses. Conservative media has told them repeatedly, and in no uncertain terms, that this is the trick being played on them by the privileged and powerful.

It’s a great story – but it certainly is not the true story.

Indeed, you may be surprised to learn that once the lion’s share of the ACA kicks in on January 1, 2014, not only are Members of Congress and their staff obligated to play by the same rules as the rest of us, they will actually be required to follow a more restrictive path to their health insurance than you and I.

The false narrative suggesting that Congress gave themselves a special deal appears to have begun with John Fund of the Wall Street Journal who wrote,

As the U.S. Office of Personnel Management notes, Members of Congress “enjoy the widest selection of health plans in the country.” According to page 114 of the Kennedy bill, a similar array of choices would not be available to other Americans in the future. Instead, they would be shunted into health insurance plans under the straightjacket of whatever the government decides is a “basic” plan.

The goal would be to restrict care for the general public in order to control costs, while making sure Congress gets the gold-plated attention it’s accustomed to. Ultimately, the rest of us would be asked to trade a private insurance company as gatekeeper for a government gatekeeper. The difference, of course, is that most of us can fire our insurance gatekeeper. Just try to do that once the government fills that role.

This line of bull was peddled to an even larger audience by Sean Hannity, a man who never met a fact that he wasn’t willing to ignore while making up a new one to better suit his purpose. During Hannity’s Fox News program of March 24, 2010, Hannity stated, without reservation, that that Members of Congress and their staff were exempt from the requirements of the Affordable Care Act.

So, here’s the real deal –As things currently stand, Members of Congress and their staff, until 2014, will continue to participate in the Federal Employees Health Benefits Program (FEHBP). This program, considered among the best in the nation, allows federal employees- including Members of Congress and their staff- to choose from a wide range of health plans and select the one that best suits their needs. Note that the current plan is neither ‘government’ insurance, ‘free’ insurance nor any other sort of sweet deal that the public has been led to believe is the case. The federal employee’s program involves private insurance policies with premiums, deductibles, co-pays, etc.

Here’s the surprise – come 2014, when the lion’s share of the ACA provisions come on line, Members of Congress and their staff will be required to buy their health insurance on an exchange. In fact, their choices will be even more limited than our own. While it is expected that some 24 million people will elect to purchase their health care policy on a state run exchange, we are not required by law to do so. Members of Congress and their staff, however, must buy their insurance in this way.

Section 1312 of the Affordable Care Act reads as follows:


(i) REQUIREMENT.-Notwithstanding any other provision of law, after the effective date of this subtitle, the only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are-

(I) created under this Act (or an amendment made by this Act); or

(II) offered through an Exchange established under this Act (or an amendment made by this Act).

(ii) DEFINITIONS.-In this section:

(I) MEMBER OF CONGRESS.-The term ”Member of Congress” means any member of the House of Representatives or the Senate.

(II) CONGRESSIONAL STAFF.-The term ”congressional staff” means all full-time and part-time employees employed by the official office of a Member of Congress, whether in Washington, DC or outside of Washington, DC.

Despite what Sean Hannity and friends would like you to believe, once we hit 2014, Members of Congress and their staff will be shopping in the same state based health care exchanges that many average Americans will be checking out for the best deals and plans available.

So, you may now cross this complaint off of your “Why I Hate Obamacare” list and see if you can come up with something based in reality. And, when you do, feel free to send them in to me and we can take a look at whether the facts match the complaints.

You might be surprised.

contact Rick at

twitter @rickungar

read Rick’s general politics column at

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Interesting, not sure whoever this person is might not be just a blog writer but once again time will tell. One thing I am noticing is the huge increase in Medicaid sign ups, since Ky. also opted out they have had 72,000 plus new signers but now they will have state ins. Same in La.and I believe I read 17 other states that opted out and are signing up hundreds of thousands for Medicaid. A great free program, no co-pay, very low prescription co-pay and access to many Dr.s, so it looks like a win-win situation.

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