Kennedy continues father's commitment to long-term care

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It was heartening this week to see Edward M. Kennedy Jr., son of the late senator, encouraging long-term care providers to push for reform. It would have made his dad proud.

After all, it was Sen. Edward Kennedy who pushed so forcefully for the Community Living Services and Supports Act, which is still holding strong. The measure has made it into the Senate reform bill, which was unveiled Wednesday night. Knowing how fast our aging population is growing, it would be progress to have a government-run long-term care program.

And there are other bright spots in proposed legislation, such as a provision to eliminate drug co-pays for assisted living dual eligible residents. House and Senate reform proposals also contain plans for commission to study Medicaid long-term services and supports. Both major long-term care associations are particularly pleased about a demonstration project that would examine a payment bundling program.

But no one can deny that any historic bill would put nursing homes in a tenuous position financially. Any final bill is certain to contain major cuts to Medicare. And no matter what the administration says, nursing homes will suffer from them. Altering the market basket, or cost-of-living update, would hurt nursing homes. It is widely known that Medicare helps to make up for Medicaid shortfalls. The American Health Care Association predicts that the House's proposed cuts to the market basket would shave off nearly $24 billion from Medicare over 10 years.

There are also pages upon pages of transparency requirements in the House bill. These would present a burden to many nursing homes, as well intentioned as they may be. 

So any final legislation would be a mixed bag. But it's worth remember that Sen. Kennedy was a powerful legislator, in part, because he mastered the art of compromise. He was willing to concede certain points in pursuit of an overriding objective. He believed in taking small steps.

Certainly a bill that just contains just one forward-thinking provision, such as the CLASS Act, would honor that legacy.

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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 Marty Stempniak.