Regardless of where you stand on the political spectrum, there is no denying that Medicaid is the by far the biggest funding source for care of those in U.S. nursing homes. It supports approximately three-fifths of the residents who receive care at nursing home facilities. A health care bill being weighed by lawmakers would enact significant cuts to the Medicaid program, and there is concern, as noted in a recent Op-Ed in The New York Times, that this could gut benefits for nursing home residents, which could mean their level of care could take a hit.
In fact, there is concern many nursing homes, without that steady income, would be forced to shutter their doors, leaving elderly residents high-and-dry.
The American Health Care Act (passed by the House but later scuttled) would reduce Medicaid funding by $834 billion. Meanwhile, the Senate’s Better Care Reconciliation Act, would still slash Medicaid funding by $772 billion by 2026. This is especially troubling considering people are living longer lives than every, with many requiring a high level of care in their last years. Almost 42 percent of nursing home patients are over the age of 85, but there are also a significant number of patients whose home-and-community-based care is covered by Medicaid as well. Because Medicaid payments for assisted living facilities has been frozen at $49 daily since 2010, many people are unable to access this option, even if they may be better-served by this than 24-7 care. The potential for these cuts would make both options much less attainable.
As it now stands, the federal government matches states when it comes to Medicaid expenditures. Poorer states have roughly 75 percent of their costs paid by the federal government. Both bills by the House and Senate could/would scrap those federal matching dollars and replace them with caps based on population.
If nursing homes that rely on Medicaid were forced to close, not only would patients be harmed, but the workers as well.
The U.S. Census Bureau reports that between 2012 and 2015, the U.S. expected to experience considerable growth of its older population. The over-65 cohort is expected to reach 84 million – more than double what it is now, as baby boomers are reaching their golden years. By 2050, all baby boomers will be over age 85. Many of those individuals are going to require nursing home care, but it remains to be seen whether such options will be available, given the potential Medicaid cuts on the horizon. Government estimates pin the number of people turning 65 who ill eventually need help with dressing, bathing, eating and other activities of daily living at 70 percent.
Financing for these vital services, however, is difficult. Many families try to handle it on their own, but are eventually forced to turn to Medicaid – not surprising given that nursing home care averages about $82,000 annually. In order to qualify, individuals have to deplete almost all their resources, save for several thousand dollars and perhaps some home equity. If these health care bills – or anything similar – are passed, the criteria for eligibility would likely become even more strict.
The other concern is that even if nursing home facilities stay open, the level of care would decline dramatically, and we would see a rising number of Orlando nursing home abuse incidents. Some may have forgotten or be too young to recall, but back in the 1970s, the nursing home system was described as “something like a Dickens novel,” with abuse and neglect rampant in long-term care facilities. Nursing homes had not enough staff, which at best meant neglect (i.e., pressure sores, infections, unmet medical needs), and at worst severe abuse that went unchecked.
It’s likely that if we want to prevent these sorts of incidents from happening on a widespread, systemic scale in the future, we need to invest more in elder care, not less.
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Additional Resources:
Seniors in nursing homes out of luck under GOP health bill, July 1, 2017, By Brendan Willians, Opinion Contributor, The Hill
More Blog Entries:
Nursing Home Injury Cases – Incidents Involving Other Patients, July 10, 2017, Orlando Nursing Home Abuse Lawyer Blog