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Health care bill’s changes to Medicaid could pose challenges for nursing home care

In this May 4, 2017, photo, President Donald Trump talks to House Speaker Paul Ryan of Wis. in the Rose Garden of the White House in Washington, after the House pushed through a health care bill. (AP Photo/Evan Vucci)

WASHINGTON (Sinclair Broadcast Group) - The Medicaid per capita allotment and the block grant provision of the American Health Care Act may impact Medicare recipients currently in nursing facilities.


According to the Congressional Budget Office, the American Health Care Act (AHCA) will cut Medicaid spending by $880 billion, over the next decade.

There are nearly 70 million Medicaid enrollees nationwide. The annual long-term service and support spending for Medicaid annually is $152 billion, according to Medicaid.gov.

In 2012 AARP issued a report outlining the accommodations for nursing facility care under Medicaid.

“Nursing facility care is a mandatory entitlement within the Medicaid program. All individuals who qualify financially for Medicaid and qualify by level of disability for nursing facility care must be allowed to receive nursing facility services,” report said.

That same report also stated that almost 60 percent of the Medicaid annual long-term service and support spending went to nursing facilities.

The American Health Care Act, creates a per capita cap on Federal Medicaid spending. This cap will distribute funding to the states based on how many people were enrolled in the program.

“If a state has excess medical assistance funds, the payment to the state for each quarter in the following year will be reduced by ¼ of the excess amount,” according to the American Health Care Act.

The other option for states would be to receive a block grant which would provide a fixed amount of funds to the state that would not be contingent on the number of enrollees.

If the cost for care rises or there are more enrollees in the Medicaid program in need of nursing facilities than the state could be without funds to provide nursing facilities to make these accommodations. This can create hurdles for Medicaid recipients currently in nursing homes if the cuts result reduced options for care or loss of care all together.

A report issued by the Henry J. Kaiser Family Foundation echoes that concern.

“States with costs that exceed the cap for their senior or disabled enrollees would need to find other revenues to maintain coverage, or reduce costs,” the report said.

However, Secretary of Health and Human Services, Tom Price, said the health care bill will lead to greater flexibility for states to provide care for Medicare and Medicaid recipients.

“The fact of the matter is that Medicaid spending under the proposal and under the budget goes up every single year. And it goes up by a factor that is great — that is equal to the cost of medical care,” Price told CNN’s ‘State of the Union,’ Sunday.


Democrats in opposition to the American Health Care Act have decried these cuts as costly to the American people.

"Republicans have now made the bill even more costly and cruel to American families, likely resulting in millions more Americans not being able to afford coverage. The American people have a right to know the full consequences of Trumpcare before their representatives vote on it,” House Minority Leader Nancy Pelosi said in a statement.


According to the Centers for Medicare and Medicaid Services, Medicaid spending grew by 9.7 percent in 2015. That is 17 percent of National Health expenditures. But the cost of nursing care facilities and continuing care retirement communities also grew by 2.7 percent.

According to AARP, while home and community care based service are on the rise for older adults and individuals with disabilities, nursing care facility costs remained nearly twice as high.

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