It seems nothing comes easy in long-term care. Regulatory change is a constant threat, more restrictive legislation is always in the works, and finding qualified workers is invariably a challenge. And funding? Well, let’s just say it’s constantly in peril.
Therefore, the fact a national Medicaid brouhaha is unfolding should not surprise anyone. But this one promises to be a cage match like no other. The good news is, senior care providers have plenty of company on their side — just like last time.
That was during President Trump’s first year. The administration then announced it would push to allow states the option of block grants for their Medicaid systems. A block grant by any other name is a cap on spending, which could lead to cutbacks in services and numbers of people served.
And now the administration has launched a big drive for Medicaid block grants again. Providers’ scars have not healed yet from the first experience.
This time, they face a wiser, more experienced opponent on the issues. Why else would the administration re-introduce such a controversial subject? Could there be something more palatable coming this time?
Some vulnerable populations, such as the disabled, are expected to be exempted from parts of the new policy, which is aimed at curbing spending in the aftermath of expanded Medicaid rolls in recent years.
That said, the block-grant issue is going to unleash all kinds of brawls in the legal system, on the airwaves and in the court of public opinion. Changing this institution in such a big way would affect everyone touched by it, and right now that’s 1 in 5 Americans.
Legal challenges are sure to be launched, and already there are doubts that anything new could be enacted for at least a year, anyway, if not much longer.
Nonetheless, a pall exists. There also are worries that the massive provider coalition won’t be strong enough to turn this one back, as it helped do before. This is not going to be a normal funding fight.
I can tell you I’ve heard countless dour forecasts and seen many worried faces among nursing home advocates through the years. But I don’t think I’ve ever seen the depth of panic as I witnessed the last time this was in the headlines.
Bundle up and start looking for allies. This one is not going to be easy, and it’s not going to be short.
