Congress pulls through on Medicaid bill

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You have to give credit where it's due. Congress deserves kudos this week for passing legislation that will extend much-needed Medicaid funding to states.

It was not an easy task. The sentiment against government spending in the House and Senate is strong—especially for healthcare and entitlement programs. It's also particularly admirable that House Speaker Nancy Pelosi managed to corral her members back from their summer recess to vote.

Nursing home organizations, which have been pushing Congress for passage of the legislation for a long time, were thrilled. It's easy to forget, but Congress has been wrestling with this legislation for months. At one time, a bill contained the doc fix (which was passed separately) and the repeal of the RUG-IV delay (which has not been acted on yet). It was this Medicaid funding portion that held up the bill's passage so many months.

It's understandable the community feels so grateful. These are desperate times for states, the source of so much Medicaid reimbursement for nursing home providers.

But at risk of dampening enthusiasm, this bill is not a panacea. Most states are in deep fiscal trouble. This increase is merely a fraction of the initial 6.2% federal medical assistance percentage (FMAP) increase states received when the healthcare reform bill passed. (This FMAP is the percentage rate used to determine the federal match rate for Medicaid.) And it's only temporary. There's a chance states' fiscal situations will improve next year, but a complete turnaround? That seems a bit of a reach.

Still, the saying goes, you have to be grateful for little things. While this money is not guaranteed for nursing homes, it will help strengthen nursing homes' position to lobby against Medicaid cuts. It's now up to the governors to acknowledge nursing homes' needs and allocate accordingly.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.