Med­i­caid cut in GOP health bill wor­ries the nurs­ing home set

‘With­out Med­i­caid sup­ple­ment­ing, I don’t know what would hap­pen’

Kuwait Times - - HEALTH & SCIENCE -

FORT LAUD­ERDALE, Florida: Amy Bernard and her brother kept their mother out of a nurs­ing home as long as they could, un­til Parkin­son’s and de­men­tia took their toll and she was se­ri­ously in­jured in a fall. Bernard is happy with her mother’s nurs­ing home care, but it comes at a steep price: $7,000 per month, an amount that would be way be­yond the older woman’s means if not for Med­i­caid, which picks up $3,000 of the tab.

Which is why Bernard and many other Amer­i­cans like her are watch­ing the health care de­bate on Capi­tol Hill with trep­i­da­tion. The Sen­ate Repub­li­cans’ plan to re­peal and re­place Pres­i­dent Barack Obama’s Af­ford­able Care Act would cut pro­jected Med­i­caid spend­ing over the next decade by 25 per­cent. Sup­port­ers of the bill say nurs­ing home sub­si­dies would not suf­fer sig­nif­i­cant cuts, but op­po­nents say they are in­evitable. The un­cer­tainty is frus­trat­ing to those who rely on them. In the case of Bernard’s 83-year-old mother, re­tired teacher Franceen Golditch, the $4,000 that she re­ceives each month from her pen­sion and So­cial Se­cu­rity goes al­most en­tirely to the nurs­ing home. “With­out Med­i­caid sup­ple­ment­ing, I don’t know what would hap­pen,” said Bernard, a self­em­ployed graphic artist in Boyn­ton Beach, Florida. She added: “I have a house and kids to sup­port my­self. I hon­estly have no an­swer.” While the fed­eral-state Med­i­caid pro­gram is most of­ten as­so­ci­ated with poor chil­dren and sin­gle moth­ers, al­most two-thirds of its spend­ing goes to the el­derly and the dis­abled, even though they make up just 1 in 4 re­cip­i­ents.

Con­gres­sional Bud­get Of­fice

The rea­son: Well over half the na­tion’s 1.3 mil­lion se­nior cit­i­zens in nurs­ing homes re­ceive Med­i­caid. The bur­den is ex­pected to bal­loon as the 74 mil­lion sur­viv­ing baby boomers - those born be­tween 1946 and 1964 get older. They are 52 to 71 now. In part be­cause of the Med­i­caid cuts, the GOP bill lacks the votes to pass in the Sen­ate, which is ex­pected to take up the mea­sure again af­ter Congress’week­long July Fourth re­cess.

The bill would cut Med­i­caid’s pro­jected bud­get over the next 10 years by a com­bined $772 bil­lion, ac­cord­ing to the Con­gres­sional Bud­get Of­fice. That would de­crease the amount pro­jected to be spent fed­er­ally on Med­i­caid dur­ing that time to about $4.2 tril­lion. Even with those cuts, nurs­ing home pa­tients would con­tinue to re­ceive sig­nif­i­cant as­sis­tance be­cause fed­eral Med­i­caid spend­ing would grow by 20 per­cent over the next decade from its cur­rent level, said Zach Hunter, a spokesman for the GOPled House Com­mit­tee on En­ergy and Com­merce, which helped write the House ver­sion of the bill.

Mean­while, he said, fed­eral reg­u­la­tions would be eased, giv­ing states more flex­i­bil­ity to tai­lor their pro­grams. The pro­posed changes are “an im­por­tant step to­wards strength­en­ing the Med­i­caid pro­gram and en­sur­ing vi­tal funds go to the most vul­ner­a­ble,”Hunter said. He said the bill makes pro­vi­sions, for ex­am­ple, for pos­si­ble med­i­cal ad­vances such as drugs for Alzheimer’s or other dis­eases of the aged.

Joe Baker, pres­i­dent of the Medicare Rights Cen­ter, an ad­vo­cacy group that op­poses the bill, said sub­stan­tial cuts even­tu­ally would hurt those who rely on nurs­ing home as­sis­tance. “You can’t say you are go­ing to save a lot of money on kids and preg­nant women be­cause there isn’t a lot of money there to save,” Baker said. “Look at the pop­u­la­tion that is cost­ing you a lot and, frankly, that is older adults and older adults who are 85-plus.”

For­mer Navy com­man­der

Medicare, the fed­eral health in­sur­ance pro­gram that pri­mar­ily cov­ers peo­ple 65 and older, does not cover long-term nurs­ing home care. To qual­ify for Med­i­caid nurs­ing-home cov­er­age, un­mar­ried se­nior cit­i­zens in most states must have in­comes of less than $2,205 per month, in­clud­ing So­cial Se­cu­rity and pen­sions. Some states have a lower limit. The thresh­old is higher for mar­ried cou­ples. Sin­gle peo­ple also must have drained their as­sets be­low $2,000, though there is an ex­emp­tion for home eq­uity.

Peo­ple with higher in­comes can be­come el­i­gi­ble if their med­i­cal and nurs­ing home ex­penses are too heavy. That is why Golditch is cov­ered. In 45 states and the Dis­trict of Columbia, Med­i­caid also cov­ers some se­nior cit­i­zens who are in as­sisted liv­ing cen­ters or need home health aides. Chuck Sch­warz, who suf­fered a stroke in 2014, said Illi­nois’ Med­i­caid pro­gram al­lows him and his wife of 60 years, Cathy, to stay at an as­sisted liv­ing com­plex in South El­gin, about 40 miles from Chicago. She has Alzheimer’s, and Sch­warz said be­ing able to visit her daily has kept them both alive. Med­i­caid pays about 85 per­cent of their $9,785 monthly bill.

“I don’t know if I will be af­fected by the cuts or not. I may not be. If they do, I don’t know what I would do,” said Sch­warz, an 82-year-old re­tired sales­man and for­mer Navy com­man­der. “We have pretty much ex­hausted our sav­ings. We didn’t ex­pect to live this long.” Daniel Rein­gold, CEO of the non­profit that runs New York City’s 1,000-bed He­brew Home at Riverdale, a nurs­ing home, said Med­i­caid cuts will re­duce the qual­ity and amount of care for the aged and sick. He said nurs­ing homes will re­duce staff and might send their res­i­dents to the hos­pi­tal for some med­i­cal pro­ce­dures, at a higher cost to the gov­ern­ment. “It is a short-sighted view,”he said. —AP

SOUTH EL­GIN, Illi­nois: Chuck Sch­warz, left, holds hand with his wife Cathy at Her­itage Woods of South El­gin in South El­gin, Ill. —AP

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