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WASHINGTON - February 24 - America's home health care recipients - many of them low-income seniors - could be forced to make a 10 percent copayment for home health care visits under a proposal being considered by the Bipartisan Commission on the Future of Medicare, Rep. Bernard Sanders (I-VT) warned today, and he has organized the fight in Congress against the plan.

"It is outrageous to keep asking people who can barely make ends meet to pay for home health care after Congress created this mess by cutting $115 billion from Medicare - $16 billion from home health care - to pay for tax cuts for millionaires and billionaires in the 1997 balanced budget legislation, which I opposed," Sanders said. "Congress has rejected smaller copayments in recent years. Now they're talking about 10 percent. This has got to stop. Congress needs to act quickly to repair the damage done two years ago. We must stop coming up with plans that force the frailest, sickest, low-income people in our country to pay for Congress' mistake."

Sanders, who led the fight in Congress against an $8 copayment proposal last year, is leading the opposition against the 10 percent proposal. He has organized bipartisan support from other House Members and has drafted a letter to Medicare Commission co-chairs Sen. John Breaux (D-LA) and Rep. Bill Thomas (R-CA), arguing against the copayment and urging its rejection by the Commission. The letter has more than 45 Members' signatures, and Sanders expects to get more.

There is currently no copayment requirement for Medicare beneficiaries who receive home health care. Sanders pointed out that many home health care recipients are frail, elderly and often living on incomes of less than $10,000 a year. They are already having trouble paying for food, housing, heat and prescription medicines they need, he said, and a 10 percent copayment would be devastating. Sanders said that, according to the Health Care Financing Administration, the average per-beneficiary reimbursement for home health care was $4,704 in 1997, the year for which most recent figures are available. A 10 percent copayment, therefore, would require the average Medicare beneficiary to pay $470 per year for home health care services. Home health care providers would also be hurt by the copayment plan.

According to the National Association for Home Care, nearly 20 percent of America's home health agencies have closed since the passage of the 1997 balanced budget legislation. Other agencies have been forced to reduce services to people needing care. NAHC, the nation's leading national home health care organization, strongly backs Sanders' efforts.

"If any copayment is adopted by the Medicare Commission, we are concerned that many of the sickest and frailest seniors will go without the care they need. We fully support Congressman Sanders' efforts to stop this outrageous copayment proposal," said NAHC President Val Halamandaris.

Many home health care agencies have indicated that, if a copayment is required, they will be forced to cover the additional costs themselves, rather than passing them along to patients. That means an additional financial drain on agencies that are already cutting back.

"Congress has already caused great hardship for some of the poorest, sickest, most vulnerable Americans," Sander said. "This is cruel; this is unnecessary; and it has got to be changed. Our seniors deserve the care they need, and neither they nor our home health care providers should be hit with higher costs that translate into reduced services. The answer is for Congress to get its priorities straight and fix this problem and not impose additional burdens on seniors and providers."