Budget-cutting efforts pick up steam as Thanksgiving deadline approaches. Home care providers may not have much to be thankful for in the super committee's budget-cutting deliberations. With up to $600 billion in Medicare cuts proposed, HHAs and hospices may have good reason to worry. Background: The so-called congressional super committee is tasked with generating at least $1.2 trillion in government spending cuts by Nov. 23. The 12-member committee has been working in relative secret since its inception this summer while being bombarded on all sides by lobbyists opposing cuts. Now the Democrats on the committee have put forth a proposal to cut $3 trillion, in part by including $400 billion in unspecified Medicare cuts. The Republicans have countered with a proposal that includes $600 billion in such cuts, according to press reports. The two parties are wrangling over whether to include tax increases in the package, and the impasse may derail the legislation altogether. If it does, a 2 percent across-the-board cut will hit programs such as Medicare. Experts continue to debate whether the across-the-board cut would be the lesser of two evils for home care. Home health agency copays are almost surely included in the package, since they have been proposed by a range of bodies including the Obama administration, the Medicare Payment Advisory Commission, and the Congressional Budget Office. The bad press the industry has received lately "make co-pays likely for our not too distant future," worries the HomeCare Association of Louisiana. Additional HHA and hospice cuts are also likely to be included in the package, expects the National Association for Home Care & Hospice. NAHC urges providers to lobby their elected representatives for no copays or cuts in the deficit reduction package. "Those patients who choose not to or are unable to receive home health care will seek services in ERs and other more costly venues," HCLA reminds.