Image of nurses' hands at computer keyboard

Lawmakers should have seen it coming. When they proposed cutting Medicare by the billions over the next decade they should have suspected that seniors would rise up to protest.

And that’s exactly what they are doing.

Now the administration is playing catch-up and trying to win back this precious voting block. They’ve got work to do. It will be hard to convince seniors that all will be OK when House legislation calls for trimming $563 billion out of Medicare’s growth rate over the next 10 years while pumping in about $320 billion.

Of course, the misinformation that is circulating on the airwaves and Web is only fanning their discontent. One healthcare provision that is adding to the hysteria is a plan to reimburse doctors who administer end-of-life care planning counseling. Talk-show hosts and others are saying that such a provision would lead to government-sponsored euthanasia. I think most people would agree that jumping to this conclusion is a little extreme.

Sensible people, especially many older adults, know how important it is to plan for end-of-life care and have advance directives.  It is important to drown out this rhetoric as noise and focus on more legitimate concerns.

Providers should worry

Of course, the administration and its powerful ally AARP point out that healthcare providers likely will see the impact of Medicare cuts more than seniors themselves.

And don’t skilled nursing facilities know it. They are doing their own lobbying campaign at the moment to convince Congress to take back proposed Medicare reductions to nursing homes in the House bill, H.R. 3200, America’s Affordable Health Choices Act of 2009.

The bill would eliminate the market basket (a cost-of-living adjuster) and recalibrate payment rates. This could lead to cuts of $33 billion to $44 billion to nursing homes over 10 years, according to the Alliance for Quality Nursing Home Care.

Both the American Association of Homes and Services for the Aging and the American Health Care Association are exhorting members to write, e-mail or visit their congressmen about the provision over this August recess.

AHCA has launched a grassroots campaign (named Save Our Seniors, no less) to educate Congress about the impact of the cuts to skilled nursing facilities in H.R. 3200. AHCA estimates that cuts in the healthcare reform bill could jeopardize 50,000 jobs nationwide in 2010 alone. That would affect the quality of care that nursing home residents receive.

So there’s the kicker. While healthier seniors may not see their Medicare coverage change, it’s probably safe to say that reform could affect more medically needy seniors after all.

And that alone is cause for concern.