The following commentary does not necessarily reflect the views of AgWeb or Farm Journal Media. The opinions expressed below are the author's own.
See the latest reader comments and hear John explain some of agriculture’s complex topics.
Last week we looked at how Medicaid is structured, and the important thing to recall is it is a joint program between the federal government and states. Thus, Medicaid is administered differently across the states. This also means any changes made by the federal government will have unique consequences depending on where you live.
Because the changes to Medicaid funding and rules have not been finalized, we can only outline some broad possibilities.
First, there seems to be no possibility of increased funding or coverage.
Second, state budgets and politics may be able to partly offset Medicaid changes by picking up more of the cost.
Third, some Medicaid cuts may be immediate, but the bulk of them will likely occur later by limiting the growth of Medicaid spending below the cost inflation for medical expenses. This is an increasingly common budgeting gimmick that postpones pain to somebody else's term of office.
One way to make such cuts is to lower payments to providers. This will likely cause fewer doctors and hospitals to accept Medicaid patients. Cuts could mean fewer applicants being accepted causing longer waitlists (which right now falls most heavily on disabled adults). Given the size of Medicaid in their budgets, many states will face serious deficits that will require state revenue increases or additional service cuts.
What we don't know is which Medicaid programs and recipients will be most affected in your state. I have focused on long term care and nursing homes. According to the administrator of our facility, Medicaid funding for the 60% of the residents is insufficient now, and here in Illinois, payments are running over three years behind. We don't know how much cost-shifting can be done by nursing homes to raise private patient fees to make up for the loss Medicaid dollars. Rural nursing homes have an additional problem of too few local residents who can pay. The industry expects staffing levels to fall. Meanwhile cuts to programs that help seniors stay at home will add more demand for nursing home beds. Finally, this change coincides with the declining health of the enormous Baby Boom generation, as well as a sharp increase in Alzheimer diagnoses.
None of this is finalized. Once some details are known, I'll share what I think is going to happen to rural health care, especially our nursing homes.
No comments have been posted to this Blog Post