WASHINGTON – The Senate approved on Thursday an amendment introduced by Sen. Susan Collins to shift $13.7 billion to Medicare for home health care over the next 10 years. The vote was 99 to 1.

“I can’t tell you how thrilled I am about the vote today,” Collins said. “I lobbied my colleagues very hard for their support, but this was even a stronger vote than I had expected.”

The $13.7 billion would be taken out of a $500 billion budget surplus fund and would not have any effect on the size of the tax cut, Collins said.

Collins’ amendment to the Senate Budget Resolution would provide the necessary money to eliminate a provision of the Balanced Budget Act of 1997 that asks for a 15 percent reduction in Medicare payments to home health agencies starting on Oct. 1, 2002.

The Balanced Budget Act was intended to slow the growth in Medicare spending, Collins said. “Unfortunately, it has produced cuts in home health spending far beyond what Congress intended, and the effects have been particularly devastating in Maine.”

She added that cuts were “simply not necessary” because “the savings targets set by the Balanced Budget Act have been far surpassed.”

In fact, she said, the most recent Congressional Budget Office projections show the post-Balanced Budget Act reductions will be about $69 billion from fiscal year 1998 to 2002, four times the $16 billion the CBO originally estimated for that time period. “This is a clear indication that the Medicare home health cutbacks have been far too deep,” Collins said.

Because of these cuts, the number of home health patients in Maine dropped 23 percent from June 1998 to March 2000, Collins said. “This means that 11,195 fewer Mainer seniors are receiving home health services.”

Home health agencies have become even more important now that an increasing number of medical procedures are performed on an outpatient basis, Collins said, adding that “recovery and care for patients with chronic diseases and conditions have increasingly been taking place in the home.”

Especially in rural areas such as Maine, she said, home health care services are essential to seniors and the disabled who cannot travel to far away hospitals. “And most elderly people don’t want to go to a hospital,” Collins said. “They prefer to receive treatments at home.”

Collins said because home health care has become such a big part of America’s health care system, it is the responsibility of Congress to ensure that the agencies that provide the care can stay in business. “An additional 15 percent cut in Medicare home health payments would ring the death knell for those low-cost agencies which are currently struggling to hang on.”

Sen. Robert C. Byrd, D-W.Va., was the only senator to vote against Collins’ amendment. He could not be reached for comment. But Collins said she thought his vote was meant as “a protest against the way the budget was brought to the floor and not against my amendment.”