Medicaid questions persist in wake of Obama victory

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While a controversial Republican-supported Medicaid block-grants option will be off the table after last week's presidential election, uncertainty will continue about nursing homes' No. 1 source of payment as President Obama's healthcare reform plans move forward.

Still included in the president's plans is a proposal to incrementally reduce provider tax rates from a maximum possible 6% in 2014 to 3.5% in 2017. Long-term care providers have vehemently opposed measure because it is projected to siphon a potential $26.3 billion in federal matching funds out of the Medicaid pool over a 10-year period.

In addition, there are no clear answers as to how states will pay for Medicaid's planned expansion starting in 2014, or how much funding will be affected by deficit reduction negotiations.

Meanwhile, more aspects of the Affordable Care Act continue to lurch closer to full implementation. Included are eligibility system reforms, reimbursement increases for primary care providers, and continuing questions on how to cut costs for people who are eligible for both Medicaid and Medicare.

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