Over the past decade, the national skilled nursing sector has incurred almost $30 billion in cuts by way of budget and regulatory reforms. The cuts have mostly affected employment and renovations for skilled nursing facilities, but both have major implications on the quality of care that their patients receive. Arguably these cuts may have a lesser effect on elderly end-users if skilled nursing providers can hone down certain overhead costs and waste. However new state budgetary woes may soon put senior services even further out of reach for an already underserved population.
Earlier this week the Texas State House Appropriations Committee approved a revised budget that would threaten to cut funding to Medicaid by $4 billion over the next two fiscal years. The cuts would translate to about a 10% funding decrease for the average nursing provider and affect close to 176,000 seniors in the state, according to AARP Texas who have taken a leading role for the opposition of the proposed bill. The bill must still be reviewed by the entire state legislature before any cuts are actually made, but until a final decision has been made both sides seem to be at a stalemate.
Nevada Governor, Brian Sandoval has also proposed a Medicaid overhaul to the tune of $10.1 million by cutting reimbursement rates to nursing homes. The Nevada Healthcare Association addressed state legislators to argue that cutting reimbursement rates for solely budgetary reasons is against the law and further stated that approving the unlawful budget cuts would also jeopardize matching federal funds. Legislators, however, maintain their position by contending that although cuts would affect the bottom-line of nursing homes throughout the state, the alternative would have been to cut optional Medicaid services altogether and limit the procedures available to beneficiaries.
In Oregon, a similar debate has gotten particularly heated over the last few weeks as state legislators try to overcome the $3.5 billion deficit. Opponents of the proposed budget claim that cuts would disproportionately affect long-term care for seniors and people with disabilities by implementing major cuts to in home care. Opponents suggest that the proposed cuts to home care might have forced affected seniors into nursing homes, but further cuts to Medicaid might make this an inaccessible option for the proportion of seniors who depend on state funding for their medical needs.
The debate over senior services has continued to escalate, especially in states where skilled nursing accounts for a significant percentage employment. In these states the impact of cuts to senior services can have somewhat of a domino effect that could hurt seniors, but also trickle down to the employment rates of medical support services and the decline in economic activity that would follow. For the time being, it seems, most states will wait for federal guidance to determine the extent to which they can cut state Medicaid funding without losing additional funding from the federal government.
