A home health copayment is, in effect, a “sick tax” that harms access to care for vulnerable seniors on fixed incomes, many of whom have multiple chronic conditions, live alone, and need home care to prevent health or safety risks that would otherwise require higher-cost services. If charged a copay, many seniors on fixed incomes will refuse the added charge on their benefits and opt out of vital home care services that help prevent hospitalization, ER visits and other emergent care.