On Friday, Dr. Tom Price was sworn in as Secretary of the Department of Health and Human Services.

His primary job will be one he clearly relishes, dismantling the Affordable Care Act. The relative merits of this objective continue to be actively debated.

Regardless, long-term care operators should cast a wary eye toward the new HHS boss for two reasons: Medicaid and Medicare. By all accounts, he plans to make changes to both programs that just might pose an existential threat to this field.

Let’s start with Medicaid. The Trump administration is hoping to save billions of tax dollars by incorporating a block-grant approach to payments. To understand why this shift would be bad for you, please revisit  the previous sentence.

Block grants are not being put in place to help you deliver better, more efficient care. They are a budget-trimming tool, pure and simple. In their most basic form, they work like this: The federal government gives states a set amount of dollars for a specific purpose, such as Medicaid. Once the money is gone, it’s gone. You happen to still be in line for payments behind other deserving groups, or those with more political clout? Too bad. You don’t get nearly enough to cover your actual caregiving costs? Tell your story walking.

To be sure, many operators have trimmed their Medicaid-payment reliance during the past decade or so. However, Medicaid still remains a major funding source. For many operators, block grants may translate to “Goodbye, Medicaid funding, hello, Mr. Bankruptcy Attorney.

Then there’s Medicare. If past performance is any indication, the forecast here is similarly disturbing.

When he was chairman of the House Budget Committee, Price was a frequent supporter of measures that enact beneficiary payment limits. Is there any reason to believe his opinion has changed?

So what is going to happen under this scenario when a maxed-out resident enters your facility? So long as you are willing to deliver free care, everything will be fine. That’s not going to be a problem, is it?

It should be noted that Price is an orthopedic surgeon. As such, he surely must be familiar with the Hippocratic oath, which calls on doctors first and foremost to “do no harm.”

Yet he’s going to actively push for “reforms” that may prevent many thousands of people from getting the care they need? Looks like the good doctor may have pledged his allegiance elsewhere.