Road trip for Medicaid relief

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The American Health Care Association is hitting the road on Tuesday. That's when the association is kicking off its 40-state Driving for Quality RV Tour.

And it couldn't come at a better moment. The Senate Thursday failed to pass legislation that would extend critical Medicaid funding to states—otherwise known as the federal medical assistance percentage (FMAP). 

“The kickoff of the AHCA/NCAL Driving for Quality Care grassroots RV tour is now perfectly timed to ramp up pressure on our lawmakers to act on this vital legislation as state budget crises persist and seniors' access to care is imperiled,” Bruce Yarwood, president and CEO of the American Health Care Association, said in a statement.

And what a defeat it was. Congress had been tinkering with this bill for weeks. First, the House passed the jobs bill that excluded the FMAP increase extension. Then the Senate took the bill and carved out the Medicare physician measure as a stand-alone to concentrate efforts on the FMAP extension. But even after Sen. Max Baucus (D-MT) whittled the 6.2% FMAP increase down, Senate Republicans rejected it.

Pricey package

It was the cost—about $24 billion—that killed it, in part. Republicans and moderate Democrats are resistant to shelling to out any more money for healthcare. This message rang like a loud gong in my ear while I was in Washington, D.C. earlier this month for AHCA's congressional briefing. Visiting some of the lawmakers on the Hill, their frustration with healthcare reform and spending on entitlement programs was palpable.

Rep. Jim Marshall (D-GA) was not shy about his dislike of healthcare reform: “We screwed up healthcare reform,” he told two members of the Georgia delegation. “We really blew it.”

He was not optimistic about his support for any future healthcare expenditures.

“We're going to cut this off at some point,” he said. “It's not whether; it's when.”

Paying for an increase in the FMAP and other healthcare spending would be fine if we can pay for it, he said. He suggested that the long-term care field find a “pay for” to offset the cost of the FMAP bill.

“We're just passing this off on the next generation,” he said. “We are being very selfish.”   

Funding emergency

That's one point of view. Meanwhile, governors and nursing homes have pleaded with Congress to pass a six-month extension of the FMAP, which is set to expire at the end of the year. AHCA talked almost exclusively about this issue to members at its congressional briefing earlier this month. State budgets are in bad shape. In response, states are trimming outlays for Medicaid and other programs.

The situation doesn't look like it will improve any time soon. Spending in fiscal year 2011 is expected to be $52 billion lower than fiscal 2008, a report from the National Governors Association and the National Association of State Budget Officers found. Twenty-eight states have proposed reducing Medicaid payments to healthcare providers in fiscal year 2011.

Well, perhaps we'll see more progress by the time the RV tour ends at its annual conference. Still, that will only be October. FMAP funds don't run out until the end of December. As far as Congress is concerned, that's a long distance off.  


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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.