A recent article in the Duluth News Tribune reported that Trumpcare would cap federal spending on Medicaid and force states, nursing homes, hospitals and others to make up the difference, which would grow over time. Medicaid has been a big part of the nation’s health-care system for over 50 years and insures nearly 1 in 5 Americans. One in every two people over the age of 65 will have some type of stay in a nursing home, with one in 10 staying longer than five years. Of those currently receiving nursing home-level care, 40 percent are under the age of 65.
A per-capita cap (sending a fixed amount to the states for each beneficiary) or a block grant (sending a fixed amount to the states for their entire program) would give states substantially less federal funding than they would get under Medicaid today, with the cuts growing larger each year.
“What a huge impact this could have, even here in Detroit Lakes,” said Janet Green, regional director of Ecumen, which owns Emmanuel Nursing Home in Detroit Lakes and manages Sunnnyside Care Center near Lake Park for Becker County.
With an aging population, Minnesota could be especially hurt by the proposed changes to Medicaid, which covers many nursing home residents.
“In Minnesota, there are a rising number of older adults and people needing Medicaid to pay for long-term health needs,” Green said.
Long-term care costs, based upon a recent survey by Genworth Financial, shows median costs for home care at $65,000 a year and a private nursing home room at $97,000 a year, according to University of Minnesota Extension. Costs like that can quickly consume a lifetime of savings, leaving people dependent on Medicaid for nursing home care.
“Any cuts in Medicaid will mean less money to pay our staff,” she said. And nursing homes, for obvious reasons, are all about people—some 70 percent of total costs are for personnel. “As you know, we have a worker shortage in Minnesota, and we have a hard time paying staff as needed,” Green said.
Loss of federal Medicaid funding could have a detrimental effect on efforts to keep people in their homes longer and out of nursing homes. But if funding for those programs goes away, more people will try to stay at home without services, and it will end up costing the system more in the long run. “People will be sicker and need more costly care,” she said.
Medicaid pays the premiums, deductibles, co-payments and other out-of-pocket costs associated with Medicare for lower-income elderly people, Medicaid changes could also hurt Medicare beneficiaries.
“Sometimes it’s all about money, and we’re not really looking at how it’s going to affect people,” Green said of the Medicaid proposal. “At the end of the day, we want to make sure we’re taking care of our elderly and vulnerable.”