All of my contracts are based on a percentage of Medicare payments so if Medicare cuts us 21% I get cut 21% across the board. My take home pay would decrease over 50%. I would need to think hard about taking Medicare and Medicaid at all if that were to occur. It won't happen because our esteemed representatives in Washington are aware of this situation. They keep us happy by making us think no raise at all in 5 years despite perpetually rising costs is a good thing by sparing us the cut at the 11th hour. Soap box.