Close up image of a caretaker helping older woman walk

Republican lawmakers in several states are using the Affordable Care Act to draw upon federal dollars and expand the Medicaid program, a notion the long-term care industry fears will sap much-needed funding in the coming years.

Medicaid expansion plans are back on the table in states like Kansas, Indiana, Utah and others. In Tennessee, business leaders have applied pressure on lawmakers to take up the slack on paying more to care for the poorest citizens. The state’s Republican Gov. Bill Haslam convened a special session this week for lawmakers to mull a plan to extend public healthcare assistance to more of the poor.

In some states such as Washington, hundreds of thousands of formerly uninsured low-income people now have coverage, according to published reports.

The skilled nursing home industry has long fretted a program expansion would force them to seek alternative funding. Medicaid already pays for the majority of nursing home costs, covering nearly 65% of all residents. Nursing homes currently take the highest share of Medicaid dollars.