Why long-term care operators are wary - and weary - of sequestration fiasco

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John O'Connor
John O'Connor
Well, here we go again.

Less than three months after President Obama and Congress narrowly avoided walking off a fiscal cliff, we're bracing for Round 2. Only this time, we're all a bit worse for wear.

For come March 1 — next Friday — automatic government spending cuts will trim 2% from Medicare payments, 5% from senior housing funding — and 5.1% from Older Americans Act home- and community-based services funding.

But unlike the last deadline, this one does not seem to have as much power to motivate. It's as if lawmakers on both sides feel that a deal is not worth the effort or required political capital.

And even if they did happen to launch into over-caffeinated overdrive, time isn't on their side. When Senators and Congressmen get back to work on Monday, they will only have four days to take action that prevents these automatic spending cuts.

That's not to say some trial balloons are not being floated. The majority leadership in the Democratic-controlled Senate served up a plan that would raise taxes on millionaires by 30%. The measure also would reduce payments for defense and farm price supports. But that scenario faces a tough fight in the Senate. It can be expected to pass the GOP-controlled House of Representatives about the same time trained chimps begin writing sonnets.

Of course, the House has its pet priorities, which are equally unpopular in the Senate. All in all, what we have here is a recipe for impasse.

So what can we expect? Most likely, dire warnings, leverage games and ducking for cover, if history is any indication.

Where does this leave long-term care providers? Not in a good place. It seems fairly likely that a Medicare haircut is imminent. It also remains to be seen if or when the big boys will get around to working something out.

Of all the gifts our Founding Fathers gave the nation, checks and balances are among the best. They have often deterred one branch of the government from exerting too much control over another. In the process, they have kept many (but not all) ill-conceived proposals from being enacted. It's hard to imagine how much policy impulse buying there would have been without them.

That noted, when the people we elect to lead us cannot seem to even agree on what day it is, things can get a bit exasperating. That's especially the case when inaction harms care and careers. The spectacle can be hard to watch. But the real pain starts after the outcomes kick in.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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