John O'Connor

When politicians talk about Medicaid funding and nursing homes these days, an unsettling theme often emerges: the need to spend less of the former on the latter.

The unspoken accusation is that nursing homes must somehow be gaming the system, and it’s high time that more deserving options — notably home- and community-based care — finally got more of the money that’s been squandered on nursing homes.

Look, I’m all for spending Medicaid dollars on long-term care services where they will do the most good. And bad facilities of any ilk should be put out of business. But far too much of the discussion we’re hearing about Medicaid spending seems to be focused on retribution rather than distribution. And frankly, it’s a bit insulting to hear so many cheap shots constantly being casually tossed at skilled care operators.

That’s why it’s so refreshing to hear a voice of reason emerge from what otherwise seems to be the torch and pitchfork crowd. One such voice belongs to Maine Gov. Paul LePage (R). Last week, he announced plans to use a Medicaid surplus to create $13 million in additional funding for the state’s 106 nursing homes. Yes, he actually thinks it makes sense to give nursing homes more Medicaid dollars. These days, that’s a fairly dangerous position for a governor of either party to embrace.

Under his plan, the state will pony up $4.6 million, which will trigger another $8.5 million in matching funds from the feds.

Critics might counter that this is a slick move by a politician trying to court campaign funds and votes from one of the state’s largest employers (nursing homes). Yeah, it might be that too. And if it is, so what?

Even if you accept such a worst-case interpretation of LePage’s motives, the move sure makes a lot more sense than block grants, divestiture, or various other schemes that are being floated in the name of Medicaid reform. And maybe, just maybe, he’s doing this because it’s the right thing to do.

Either way, thousands of the state’s residents will continue to receive sorely-needed care and assistance. And that’s a bad thing?

John O’Connor is the Editorial Director, Vice President and Associate Publisher at McKnight’s.