I Guess the Nursing Homes don’t care
With all the focus on Medicaid, I have been wondering; why haven’t we heard from the long-term care industry? Surely they must be hearing about the potential cut of $880 billion within the Medicaid budget. Oh, and this is a minimum directive given to the committees of jurisdiction as noted in their 58 page budget outline they just passed. This is a nice discussion with Congressman Brendon Boyle on the Republican game (ignore the video title).
Regarding the following, I could not find direct numbers, so some simple math is involved. However, being exact to the dollar is not the goal, it is about finding an estimate as to what the nursing home industry is facing.
These are some numbers based on the 2023 Medicaid budget. The total federal and state spending for that year for Medicaid was $880 billion. An interesting coincidence? 69% ($606B) was picked up by the Federal government. There are some interesting maps as to spending via states also.
I used this site for the following numbers. In 2020, $217 billion in total federal and state was spent on long term support and services. According to Statista $683 billion in total was spent on Medicaid. Thus, 31.8% of the total was on long term care. From the long term care study, 1.4 million used only institutional long-term care. The average per person was $47,279 producing a total of $66,190,600,000. It represents 30.5% of the total medicaid spent. If we use the 69% factor representing the federal share of the total spent by medicare, we get: $66.2 x 0.69 = $45.7 billion as the federal government share for institutional long-term care. Using the 69% as the share of the total we get $149,73 billion. The portion of this that is for institutional long-term care is: 45.7/149.73 = 30.5%
Looking at 2023, we can use the 31.8% for long term care which gives us $192.7 billion paid by the federal government. (606 x 0.318) We can use the 30.5% to find the portion that is institutional care. $58.8 billion. (192.7 x .0305)
So, if the cut at a minimum is going to be $880 billion, the 2023 total of state and federal spending is what the Republicans are working to cut going forward. Of this number, $58.8 billion is the estimate at stake for the nursing home industry. Of course, if the federal funds are cut, the states are going to have to cut their share too.
So, why have we not heard from the nursing home industry? I mean, back in 2015, in my neck of the woods, a month in the nursing home was $10 to $12 thousand. I am confident the labor class cannot afford this, and I doubt that Walmart or Amazon can work their pricing magic on it. So why has the nursing home industry not come out against this Republican bulldozing of this part of the budget?
My sense is that no corporate power structure is willing to speak up to challenge Republican hegemony at this point. The big nursing home operators will be working behind the scenes to lobby a few on the fence Republicans.
Medicaid long term care also goes to adult foster care (4 or less patients) and adult care homes (10 or less patients). There are lots of these all over the country but they don’t have much collective political power. Many are run by individuals or small businesses.
@Jim,
Major cuts to Medicaid will impact the economies and voters of every state, including deep red states. Medicaid funds fuel spending beyond simply the beneficiaries. These folks need to call/write their Congressmen describing the consequences to their state and their voters.
Yep!
Some people and organizations need to start stomping around making a lot of noise about the consequences to cuts. With the Feds involved more so with Medicaid during the pandemic, the playing table has level for Medicaid. Even with the ACA, enough was done by Biden so the costs of commercial insurance was covered beyond 400% of FPL. This is all going away . . . as you already know.