We measure our communities by how we care for one another — especially our elders. Here in Massachusetts, where one in six residents is already over 65, home health care is what allows thousands to age with dignity and independence. Yet once again, that care is on the chopping block.

The Centers for Medicare & Medicaid Services has proposed yet another round of cuts to Medicare’s home health benefit — a 6.4 percent reduction for 2026, on top of years of payment cuts that have already pushed agencies to the brink. If approved, this would mean a loss of more than $1.1 billion nationally next year alone.

Let’s be clear about what’s at stake. Here in Massachusetts, more than 100,000 residents depend on Medicare home health services each year. These are people recovering from strokes, managing heart disease, or living with chronic conditions that require skilled nursing, therapy, or daily assistance. For them, home health care isn’t a luxury — it’s survival. It’s the difference between healing at home or ending up back in the hospital.

And it’s not just good for patients — it’s smart for taxpayers. Between 2024 and 2027, Medicare home health is projected to save $3.4 billion by reducing costly hospitalizations and emergency room visits. At a time when policymakers are focused on lowering health care costs, Washington should be investing in what works — not cutting it.

Yet here we are again. For the fourth straight year, CMS is targeting the very program that allows people to age safely and affordably at home. The consequences are already visible: staffing shortages, shrinking service areas, and closed doors in communities that can least afford to lose access. According to the Massachusetts Health & Hospital Association, one in five patients ready to leave the hospital is waiting for home health care. Every delay means longer hospital stays, higher costs, and sometimes loss of life.

A study from UnitedHealthcare’s Optum Group found that patients denied home health services after hospitalization were 42 percent more likely to die within 30 days than those who received care at home. That’s not a statistic — that’s someone’s mother, father, or grandparent.

Moreover, these cuts threaten the very existence of home health agencies in our state. The MHA report highlights ongoing challenges — staffing shortages, rising costs, and inadequate reimbursement — that make survival difficult even before another reduction takes effect. Some agencies have already been forced to shrink their service areas, leaving fewer options for seniors in rural or underserved regions. If these cuts proceed, more agencies will close or consolidate, and over one-third of Massachusetts providers could see margins fall below zero.

The workforce impact cannot be ignored. Home health care supports more than 57,000 jobs across Massachusetts, from nurses and therapists to home health aides and administrative staff. These professionals are the backbone of community-based care, but reimbursement rates haven’t kept pace with rising wages and competition from other industries. Agencies are losing workers to hospitals, retail, and food service — not because caregivers don’t love their work, but because they simply can’t afford to stay. When those positions go unfilled, patients wait longer or go without care entirely, deepening the crisis.

This is not a partisan issue. Democrats and Republicans alike have spoken out against these cuts. Hospitals, providers, and patient advocates all agree: the Medicare home health benefit is vital, cost-effective, and already stretched thin.

If we want a health care system that reflects our values — one that honors our elders and invests in care, not bureaucracy — then Congress must act now. The Home Health Stabilization Act of 2025 (H.R. 5142) would prevent these cuts and protect the Medicare home health benefit for years to come.

We cannot keep asking caregivers to do more with less. We cannot tell our seniors that the care they need — the care that allows them to live in their own homes — is suddenly out of reach. By investing in home health care and the professionals who deliver it, we can strengthen families, save taxpayer dollars, and keep more seniors where they most want to be — in their own homes.

This is about fairness, compassion, and common sense. Because in the end, the measure of any society is how it treats its most vulnerable. Here in Massachusetts, and across this country, let’s choose care over cuts — and people over policy.