The Concord Monitor allowed Brendan Williams, the president and CEO of the New Hampshire Health Care Association, to share his thoughts. His excellent editorial is below.

“Give the Trump administration credit: Having failed to get congressional authorization to decimate the Medicaid safety net for the poor, it is now trying to circumvent Congress in its dogged attempt to cut the lifeline that 62 percent of nursing home residents, for example, depend upon.

The administration would reportedly do this by unilaterally imposing “block grants” or “caps” upon state Medicaid spending. This would upend the traditional formula where the federal government matches state spending on no less than a dollar-for-dollar basis, based upon a state’s per capita personal income relative to the national average. There are 14 states, including ours, where the federal government pays only 50 percent of the overall Medicaid cost of nursing home care, while in Mississippi it pays the most: 76.39 percent of the cost.

This scheme could not come at a worse time for nursing home care. Nursing homes throughout the country are closing due to inadequate state funding. In tiny Selby, S.D., (population around 642) residents had to raise $500,000 to keep their town’s nursing home from closing. How much more would they have had to come up with if there was a new restriction upon how much state spending the federal government would match? In Texas, the state’s largest nursing home provider filed for bankruptcy in December, citing Medicaid reimbursement.

In New Hampshire, nursing home rates went up only 17 cents per resident per day on Jan. 1. And yet New Hampshire has the nation’s second-oldest population and its third-lowest unemployment rate.

Providers are already struggling to recruit, and retain, caregivers within limited means. President Trump advertised himself to New Hampshire voters, on Twitter (of course), as “the first and only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid.” Yet as president he has incessantly sought to break this promise, perhaps now to offset the bankrupting costs of the tax breaks he pushed – which are creating record deficits.

Perhaps the Trump administration figures these caregivers, and their vulnerable wards, are so powerless that it can further disregard them. They’re just poor women, right? But it would not only be nursing home care that would suffer. Home- and community-based services for Medicaid long-term care would be victimized, too. Our nation’s roughly 2.1 million home care workers make a median wage of $11.03 an hour, according to PHI. More than half must rely upon public assistance themselves, in many cases while serving those on public assistance. But maybe they, too, are easy to ignore. After all, 87 percent are women, and 30 percent are immigrants. Many of those immigrants come from “hole countries” – as Trump has described them.

In signing Medicare and Medicaid into law in 1965, an emotional President Lyndon Johnson stated that “there are those alone in suffering who will now hear the sound of some approaching footsteps coming to help.” If only those were the footsteps those suffering now hear.


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