SAN DIEGO — It’s likely the November elections will end in a split, with Democrats taking the House and Republicans holding onto the Senate, and that outcome could prove ideal for the nursing home field.
Clifton Porter II, head of government affairs for the American Health Care Association, delivered that message Tuesday at the annual meeting for the industry’s largest trade group. The AHCA’s chief lobbyist noted that the left seems to have a penchant for heaping regulations upon nursing homes, while the right often has its crosshairs trained on slashing payments.
“Republicans want to cut your jugular vein, folks. It’s called Medicaid. And Democrats want to cut your femoral artery. It’s called more regulation and let’s figure out a way to sue you into oblivion,” Porter told attendees. “There’s always these two forces at work, any of which, if left to their devices and in quote ‘control,’ we die. So, it’s important that we not only have relationships, but for us at least, it’s good to have some check and some balance where each is keeping the other honest on the issues that are important to us.”
Porter’s comments are in stark contrast from outright optimism after Trump was elected. That bright outlook was soon shattered when the president pushed hard for Medicaid payment changes that would have hammered skilled nursing providers had Congress passed them.
AHCA officials noted Tuesday that a split is currently anticipated after November balloting. Current probabilities, they said, give the Democrats an 80% chance of taking between 15 to 54 House seats in November. They need around 25 more seats to take over Congress. Meanwhile, Republicans have about the same likelihood, 80%, of retaining control in the Senate. Such a split in the chambers would likely mean that little new lawmaking would occur over the next two years.
On the other hand, Republicans keeping control in both chambers would likely mean a continued business-friendly legislative agenda of regulatory relief — but also further attempts to slash Medicaid. A Democratic sweep would still be held somewhat in check by a Republican White house. There’s always the possibility, too, that skilled care could be harmed if a compromise deal between the two parties leads to a budget deal that sacrifices provider payments, Porter added.
“There is a real risk that even in divided government, we get caught in the maelstrom, and it’s a concern,” he said. “There is a situation coming up which relates to budget caps. It’s very technical, but the reality is they’re going to need some money. It’s a lot. And if they need a lot of money and they have to strike a deal, then everybody’s vulnerable. We don’t want to get swept up in some grand bargain where we end up being on the menu.”
Regardless of what happens this November, Porter said AHCA will remain intently focused on those budget caps, implementation of the new Patient Driven Payment Model and educating legislators about the dire financial state of nursing homes. He pointed to a recent report from CliftonLarsonAllen, which pegged skilled nursing’s average margins at around 0%.
“You have a responsibility, folks. I know it’s my job here to represent you professionally in D.C., but I can’t do my job if they don’t know what the heck is going on,” he said in an appeal to the large crowd. “That’s your job. You’re a lobbyist, too. I’m irritated about what’s going on in the marketplace, but I need you fired up as well.”