Nursing home bill not ‘granny tax’; it’s way to improve care for elderly
The political professionals in Austin trying to kill my effort to improve Texas nursing homes by calling it a “granny tax” should be ashamed of themselves.
No one is talking about taxing anyone’s grandma — but “facts” like that can hurt real people if left unrefuted. I am writing this to set the record straight.
There is no argument that long-term care is underfunded in Texas. For more than two decades now, I’ve seen the nursing homes I visit have the same struggles: low staffing levels and turnover as high as 90 percent for registered nurses, caused by the state’s low Medicaid reimbursement rate.
House Bill 2766, scheduled for floor debate today, would bring in much-needed funding to improve Texas nursing homes without increased state spending. This new money would enable nursing home owners across the state to raise wages, improve training and invest to enhance their facilities.
HB 2766 would help nursing home owners retain good staff; that would improve the quality of care more than any thing I can think of. In a long-term care setting, a familiar face with personal knowledge of a resident’s needs and routines can make all the difference.
HB 2766 would do this by creating the Nursing Facility Reinvestment Allowance, or NFRA. The NFRA will allow nursing home owners to put up their own dollars to pull down additional federal government dollars.
The plan is simple: Each nursing home would put up the same amount per resident day. When the federal dollars are returned, nursing homes would see an increase in their Medicaid payment. Under the NFRA, nursing homes would have the opportunity to earn additional reimbursement if they meet certain quality metrics.
The wording of the bill expressly prohibits the nursing homes from passing on the allowance to their patients, either directly or indirectly. The fee comes from the nursing home’s revenue — not the residents.
Near the end of their life, many Texans deplete their financial assets — and for the first time they need help.
Talking about Medicaid and nursing homes isn’t just a discussion about poor people, but about the elderly who have outlived their savings. It affects middle-income Texans as well.
In fact, a majority of nursing home residents rely on Medicaid.
For a patient in a nursing home to be eligible for Medicaid, they must “spend down” to an income of less than $2,200 per month and have assets of less than $2,000. They may have a house, car and a burial policy. By law, these patients on Medicaid cannot be assessed any extra payment or bill from the nursing home.
The NFRA is an idea brought forward by long-term care providers themselves. It does not expand Medicaid. It does not add to our state budget. It allows Texas to capture federal dollars to supplement health care funding just like 43 other states are doing.
It’s a smart way to improve long-term care and avoid using state revenue. It’s also the only viable plan on the table right now to improve Texas nursing homes. For me, that makes it a no-brainer.
As a Christian, I want to ensure our elderly receive quality care in the final stages of life. As a conservative Republican, I want to see that we meet the needs of Texans in a fiscally responsible way.
The NFRA meets both these obligations — and that is why I am proud to work for its passage.
City contractors recently completed an excellent and professional resurfacing
President Donald Trump has rolled out a one-page guideline for tax reform.
What that document did not address was how capital gains and dividend income would be treated. There are two primary choices:
Revert to former President Ronald Reagan’s Tax Reform Act of 1986 that taxed capital gains, dividends, wages and other income at similar tax rates.
Continue the existing law that allows capital gains and dividends to be taxed at lower rates than wages and other income.
We now know that Trump chose the second option. Treasury Secretary Steven Mnuchin revealed at a recent White House briefing that capital gains and dividends would continue receiving favorable tax treatment.
Once again, the wealthy will be the primary beneficiaries of this choice. According to a Pew Research Center study last year, this favorable tax treatment resulted in a loss of tax revenue of $134.6 billion for fiscal 2016.