John O’Connor

So here we go again with the political gamesmanship.

This time, the spotlight is shining on Sen. Joe Manchin (D-WV). At issue is whether he will remember he was elected as a Democrat. He sure seems to be struggling with that concept lately.

Why should that matter? Because West Virginia’s senior senator is the guy holding up a budget reconciliation bill that could bring a ton of money to the long-term care field.

It’s not yet clear whether he’s playing Chicken in order to cadge some additional concessions, or if he is truly committed to a $1.5 trillion ceiling on the measure. Either way, he now holds the deciding vote.

Ironically, Manchin told some West Virginians Thursday that he’s in favor of things like expanded Medicare coverage and other social supports for his constituents. That shouldn’t be too surprising, considering at least 16% of the state’s residents now live below the poverty line.

But by unexpectedly insisting that his top-line limit would be $2 trillion less than the number he voted for in the Senate budget resolution a month prior, he put progress on hold. Will he eventually come around for the Democrats? Maybe. Maybe not. It’s all just a game, apparently.

But this is hardly a game for long-term care operators. By some estimates, more than half could be out of business in less than a year unless some financial assistance arrives.

Maybe it’s a bit unfair to single out Manchin. Truth be told, many lawmakers have a lot of nerve claiming they are in the business of public service. What all too many of them actually do is perform unspeakable acts in exchange for money.

The generally-accepted term for that kind of work is not public service, by the way.

So we’ll see what happens. Regardless, Manchin is in a pretty good place right now. He has a ton of leverage. And the absolute worst thing that can happen is he might lose his job.

Unfortunately for providers, a nay vote by Manchin could cost a whole lot more.

 John O’Connor is Editorial Director for McKnight’s.