What's happening in the Senate is no thing of beauty

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John O'Connor
John O'Connor

President Trump recently tweeted that Congress should enact a “beautiful new HealthCare bill” before taking its August break.

Senate Majority Leader Mitch McConnell's latest effort to achieve this objective again reminds us that beauty tends to reside in the eyes of the beholder.

For if you happen to be in the eldercare services field, this latest legislative package is one ugly duckling. That is, unless you enjoy the sight of your largest funding source — Medicaid — shrinking by $772 billion over the next decade.

Nor are you likely to find anything aesthetically pleasing in a per-capita cap contained in the “Better Care Reconciliation Act of 2017.”

Responding to the Senate measure released Thursday, LeadingAge noted that leaving the proposed reductions in place will effectively “end Medicaid as we know it today.”

American Health Care Association/National Center for Assisted Living President and CEO Mark Parkinson also expressed his group's disappointment with “major flaws.” Parkinson singled out an unfavorable Medicaid growth rate formula and provider tax reductions as particularly troublesome for providers.

To be sure, these are all valid criticisms. Sadly, they may also be irrelevant.

It's easy to get so caught up in this legislation's shortfalls that its purpose is overlooked. And this legislation was proposed for one reason and one reason only: to pry loose enough non-committed Republican lawmakers to get it through the Senate. Essentially, it's been loaded up with custom-made sweeteners (such as more liberal insurance coverage options) to sway GOP doubters.

Getting the required 50 votes remains a challenge, as Senate Republicans don't all sing from the same hymnal.  The more conservative members want a new law that goes as close to 180 degrees away from Obamacare as possible. But party moderates fear that coverage cuts in the new alternatives could hurt constituents (and by extension, their own re-election chances).

The long-term care field is spending more money than ever on lobbying efforts. But with all due respect, this sector is still largely on the outside looking in. Compared to the funds being doled out by drug companies, insurers, hospitals and physicians, well, there's just no comparison.

Does that mean the long-term care field will again get fleeced? Not necessarily. After all, other providers are equally aghast at the Medicaid-cutting proposals. But you can bet the big boys will eat first.

As for whatever is left over? Let's just say it might not be much to look at.

Email John O'Connor at john.oconnor@mcknights.com.


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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.