WASHINGTON, DC – U.S. Senator Pat Roberts today conveyed his concerns regarding proposed cuts to Medicare, Medicaid and rural health programs to Department of Health and Human Service Secretary Michael Leavitt at a hearing of the Senate Finance Committee regarding the President’s Fiscal Year 2009 Budget Proposal.

The Senator’s remarks follow an address last week to the National Rural Health Association and reflect his legislative priorities for the year as the new Co-Chairman of the bi-partisan Senate Rural Health Care Caucus, as a member of the Senate Committee on Finance and the Senate Health, Education, Labor and Pensions (HELP) Committee.

Senator Roberts made the following remarks:

"I have strong concerns with some of the proposals included in the president’s budget to reduce funding for rural health programs and Medicare and Medicaid providers.

"First, the president’s budget proposes a $150 million cut in rural health programs at the Health Resources and Services Administration.

"Two programs - the Rural Outreach Grants and Rural Hospital Flexibility Grants - are proposed for elimination, yet have been vital to the success of our rural health delivery system in Kansas. Several other rural programs are proposed for flat funding, yet the needs of our rural communities continue to grow.

"In addition, the budget proposes to reduce funding for the National Health Service Corps and completely eliminate the Title VII Health Professions programs. In Kansas, we rely on both of these programs to get doctors and other health professionals to serve and understand the needs of our rural areas.

"In fact, the Senate HELP Committee - of which I am also a member - recently unanimously approved legislation to renew the National Health Service Corps program and provide for increased funding over the next five years.

"The president’s budget also proposes significant reductions in the Medicare and Medicaid programs for hospitals, home health providers, nursing homes and others.

"I agree that we need to return to a policy of fiscal responsibility and get a handle on the growth in Medicare and Medicaid spending so these programs are viable and sustainable for future generations.

"However, I certainly do NOT want to be in the business of tying the hands of our health care providers, especially those in our rural areas, and ultimately harming our seniors and low-income populations by restricting their access to care.

"This is why we must proceed with caution on any efforts to curb spending for Medicare or Medicaid.

"The largest reductions in your budget come from freezing hospital payments over the next three years.

"My hospitals in Kansas have analyzed this proposal and estimate that all of the payment reductions combined would translate to a $653 million cut to our Kansas hospitals over the next five years!

"Alarmingly, from the years 2000 to 2006 in Kansas, our hospitals statewide have experienced losses for treating Medicare patients. In fact, the statewide Medicare margin in 2006 was negative 2.percent.

"One of our larger hospitals in the Kansas City area experienced Medicare losses of 13 percent in 2006. Another smaller hospital in central Kansas which serves many of our rural communities had a Medicare margin of negative 8 percent in 2006.

"Given all of this, I just don’t see the president’s proposed payment freezes as sustainable options for my hospitals in Kansas.

"I also have serious concerns with the various proposals in the president’s budget to reduce funding for home health care.

"My colleagues here on the Finance Committee know that I am an outspoken advocate for our home health community. Some might even call me obstreperous.

"But, I do my rant over and over again because I strongly believe in the great service that our home health folks provide for our seniors, and fear that further reductions in their Medicare payments will devastate their ability to provide care.

"In particular, I am extremely disappointed that the president's budget again proposes to cut the Medicare home oxygen benefit by over 60% by further reducing the rental period for home oxygen.

"Home oxygen patients and providers are already about to undergo tremendous change in the next 10 months due to the implementation of the competitive bidding program - which has created confusion and exasperation among home health providers.

"In fact, we are still waiting to hear from CMS on how many contracts were awarded for Round 1 of the program - even though CMS has announced plans to move to Round 2 in 70 more cities later this year without any evidence of success - or failure!

"Next January will also bring the end of certain monthly home oxygen provider payments, and the transfer of equipment ownership to thousands of seniors.

"This is the perfect storm, and I again want to be on record stating that we should not exacerbate this by further reducing the oxygen benefit or deepening home health cuts before we know the full impact of existing cuts and policies on Medicare beneficiaries.

"I know Senators Crapo and Salazar have also raised serious concerns with reductions in home oxygen, and I look forward to continuing this dialogue with the Finance Committee on this and other Medicare issues this spring.

"Mr. Secretary, I thank you for testifying today. We may not see eye to eye on a lot of your proposals, but I do look forward to continuing to work with you."

In June, Senator Roberts, Kent Conrad (D-ND) and Tom Harkin (D-IA), introduced critical rural health care legislation, named in honor of the late Senator Craig Thomas (R-WY), to help shoulder the financial burden rural health care providers have when caring for small communities. The Craig Thomas Rural Hospital and Provider Equity (R-HoPE) Act of 2007, makes changes to Medicare regulations for rural hospitals and providers recognizing the difficulty in achieving the same economies of scale as large urban facilities. These changes include changes to lab, ambulance, home health care, hospice and rural clinic Medicare reimbursements.

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