The American Association for Homecare (AAHomecare) has released its first formal comments on H.R. 1, nicknamed the “One Big, Beautiful Bill” that passed the U.S. House of Representatives on May 22.
In its May 28 bulletin, AAHomecare referenced scoring from the Congressional Budget Office in saying the bill’s work or school requirements for Medicaid patients “could result in 7.6 million individuals losing coverage and more than $600 billion in decreased spending in the program over the next 10 years.”
“The bill sets a deadline of December 31, 2026, for all states to begin verifying work or exemption status at the time of both enrollment and eligibility renewal,” AAHomecare added.
The 1,116-page bill also requires using artificial intelligence (AI) to find and recover improper payments for Medicare parts A and B, with an implementation deadline of Jan. 1, 2027. “The bill directs HHS [Department of Health & Human Services] to produce an annual report on the success of the new AI tools, including detailing reasons for ‘failure’ in the event their adoption does not achieve a 50% decrease in the improper payment rate,” AAHomecare said. “The bill allocates $25 million from hospital and supplementary insurance funds for FY [fiscal year] 2025 to begin the AI effort.”
While potential Medicaid cuts have dominated headlines, AAHomecare said the bill “could also result in a 4% cut to Medicare reimbursement rates across the full spectrum of health-care providers automatically triggered by legislation that causes significant debt increases — these are commonly known as PAYGO cuts, referring to the Pay-As-You-Go Act of 2010 that created them.”
PAYGO cuts could be avoided, AAHomecare said, citing “meeting a statutory requirement for a 60-vote threshold in the Senate. Congress could take that action any time before the end of 2025 to prevent those cuts from beginning in CY [calendar year] 2026.”
The association added it will continue to study the bill “and developments that could affect the HME [home medical equipment] community as it is considered by the Senate.” Medicaid changes “remain very fluid, as some Republican senators have voiced concerns over the potential impacts on Medicare beneficiaries in their states.”
While supporters of the bill have denied that Medicaid cuts would impact people with disabilities, advocacy groups including United Spinal Association have strongly disagreed and are urging stakeholders to share their concerns with legislators.
