Home healthcare plays a vital role for many Americans.
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Earlier this year, the Centers for Medicare & Medicaid Services, the federal agency that runs the Medicare program, issued a proposed rule for the home health prospective payment system. The rule would reduce home healthcare payments by an estimated 6.4%, or $1.13 billion in 2026, relative to 2025. That reduction follows on the heels of nearly 9% in cuts already in place from 2023 through 2025.
The cuts are aimed at saving Medicare dollars. Medicare is a federal health insurance program that mainly covers people based on age and specific health conditions. It is available to those aged 65 or older, regardless of income, as well as to some younger individuals with disabilities. It is a federal program—you typically sign up for Medicare through Social Security.
Medicare is largely paid for by payroll taxes—along with Social Security taxes, it’s withheld from your paycheck and submitted to the federal government (some Medicare funding also comes from premiums from optional services).
It’s one of the largest sources of healthcare in America. In 2023, Medicare covered over 66.7 million people. Total expenditures in 2023 were just over $1 trillion.
The stated goal of the recent rule is cost-cutting, but critics and healthcare providers say it will restrict access to care and strain home health providers’ referral partners. It could also be more expensive for taxpayers: When patients are unable to access home health care, that often means more Medicare spending, thanks to increased emergency department visits and more expensive care in hospitals and rehabilitation centers.
(You can learn more about Medicare—and how it’s different from Medicaid—here.)
Debbie Stabenow, the former Senator from Michigan, suggests there’s a better alternative making or pausing cuts: root out existing fraud. Here’s what she has to say:
Home Health Care Services In America
I think it’s safe to say that access to quality home health care when you need it is a priority for every American. Over 10,000 public comment letters have just flooded into the Centers for Medicare and Medicaid Services (CMS) this week, as Americans voiced deep concern over CMS’s proposed 2026 Medicare home health benefit cuts—reductions that could jeopardize care for the millions who depend on it to stay safe, independent, and at home.
As loved ones and friends age or battle chronic conditions, they have been able to receive the care they need through the Medicare home health benefit without having to be uprooted and institutionalized. Again and again, the value of home health care is powerfully clear, as dedicated care teams deliver high-quality, low-cost care that enables patients to retain the dignity of independent living.
But now this benefit is in danger of being cut for the millions of Americans who rely on essential home health care.
That’s why making sure there is adequate funding for quality home health is so important. And it’s essential that there be integrity and accountability in the system, so every dollar goes to those who need care.
This has become a very serious issue as we watch what is happening on the other side of the country from my state of Michigan.
In Los Angeles, fraud schemes tied to hospice have become so aggressive and outrageous, they are distorting payment rates nationwide. With the audacity one might associate with an action movie, L.A. criminal rings are submitting false claims to the Medicare program and then laundering the billions of dollars they are bilking from taxpayers.
The problem in L.A. is so damaging, in fact, it is getting the high-level intervention it deserves. The Department of Justice is responding, as are Immigration and Customs Enforcement (ICE) agents and local law enforcement. While that’s a very good start, more is needed. Congress and the White House said they were targeting Medicaid fraud in the Big Beautiful Bill Act (BBBA). So, in addition to combatting fraud in hospice, they should be prioritizing the bad actors who are committing home health fraud – not cutting critically needed home health services!
As CMS Administrator Mehmet Oz and Deputy Administrator Kim Brandt recently wrote in the Los Angeles Times, criminals are bilking the Medicare program “using fake providers, ghost patients, shell companies and offshore money laundering schemes that prey on vulnerable seniors and take advantage of outdated billing systems.” As a result, they have launched a new Fraud War Room to take tough, targeted action.
As a decades-long champion for home-based care, I know this approach isn’t just needed—it is the very best thing that can happen for home health care.
But there’s a big problem! As fraud in LA is addressed, a new proposal has just been unveiled in Washington that would inflict the BIGGEST cuts ever on Medicare’s home health program. If finalized later this year, this enormous cut would take more than $1.1 billion in funding from Americans who need and deserve care and those providers who serve them with compassion and integrity—all while criminal fraud continues.
In response, some in the home health community are calling for “pause” legislation that would freeze current home health payment policy, meaning any additional payment cuts next year. However, a pause would inadvertently shelter fraud schemes by preserving the status quo, meaning claims and payments would continue to be processed and paid. By seeking to keep the program exactly as it is, this measure would unintentionally enable fraudsters to continue their criminal acts.
And that simply cannot be allowed.
When I served in the U.S. Senate, I introduced several pause bills with my friend, Senator Susan Collins of Maine, that made sense at that time. But now with the revelations of outrageous fraud that have been uncovered, it is clear that a pause would only punish those doing the right thing while allowing the fraud to continue.
Rather than impose the largest reimbursement cuts ever or pursue a pause, Congress should first direct the Health and Human Services (HHS) Secretary to use the existing authority that Congress gave him to correct for fraud-driven and other data related payment distortions and quickly recalculate home health payments through emergency rulemaking to ensure fair and accurate reimbursement.
This rule could also deploy targeted action in high-fraud areas like L.A., including county-level fraud triggers, in-depth audits, and temporary moratoria on new provider enrollment. Just as important, it would build on successful precedent, targeting those who are defrauding the rest of us.
Put simply, Fight Fraud First! Don’t cut home health care that people all across our country need and deserve.
About Debbie Stabenow
The Hon. Debbie Stabenow, the first woman elected to the U.S. Senate from Michigan, was a health care leader in Congress for nearly three decades. She held senior positions on the Senate Finance Committee, Senate Agriculture , Nutrition and Forestry Committee, and in Senate Leadership. Widely respected for her commitment to public service and ability to build bipartisan coalitions, Senator Stabenow now serves as a Senior Policy Advisor for Liberty Partners Group.