Tough choice for many operators: vote with heart or wallet?

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John O'Connor, editorial director, McKnight's Long-Term Care News
John O'Connor, editorial director, McKnight's Long-Term Care News
A friend once told me that long-term care operators are Republicans who make a living off Democratic policies.

If that's the case, many of these folks may have to hold their noses when they cast votes in November. For as we saw this week, Republican National Convention delegates have approved a platform that would eviscerate many of the Medicaid and Medicare payments that facilities now count on.

In the case of Medicaid, delegates voted to repeal the Affordable Care Act's massive Medicaid expansion provisions. Instead, Medicaid would be converted into a block grant program.

Here's how block grants work: States would be given a bag of money each year to cover all their Medicaid services. What happens if the money runs out or if there is not enough for long-term care services? The short answer is that things could get pretty ugly.

Essentially, operators would have to compete with other programs for the poor, and convince their state's bean counters that seniors' needs should take priority. In other words, block grants answer the question of how do you enact healthcare rationing without calling it healthcare rationing.

By the way, please, don't shoot the messenger. I'm not trying to cadge Democratic votes here. But if you think Medicaid has been miserly for the past 20 years or so, just wait until block grants start paying your bills.

In their zeal to kick Obamacare to the curb, RNC delegates also voted to convert Medicare to a “premium support” model. While seniors could opt to keep Medicare as is, they could also pick vouchers.  While this shift could help providers that are selected, it would also harm those who are not.

These proposed changes are going to leave many nursing home operators with a tough choice when they enter the polling booth.

On the one hand, they can vote for the guy they can't stand (Barack Obama), who will likely push for helpful payment policies. Or they can vote for the guy they like (Mitt Romney) — who might just put them in the poor house.

Should be an interesting election.

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.

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