President Obama's proposed budget for 2012 may not include a home health copayment, but that doesn't mean the copay is off the table. The Congressional Budget Office includes a home health agency copay as one of its budget options for reducing the deficit. A 10 percent per episode copay would strip $40 billion from federal spending in the 2012-2021 time period, the CBO says in a new report. Utilization would decrease because beneficiaries would use the service more cost-consciously, CBO predicts. The report is at www.cbo.gov/ftpdocs/120xx/doc12085/03-10-ReducingTheDeficit.pdf.