Elderly Americans, many of them in fragile conditions of health, are among the many potential victims in the ongoing political catfight over budget cuts and taxes. And the long-term care industry appears to have had enough.
On September 17, the American Health Care Association (AHCA) unveiled a television ad campaign to air on cable outlets popular with lawmakers and staffers, MSNBC, CNN and FOX News. The ad features a woman whose ability to walk was preserved by a skilled nursing home following a catastrophic auto accident. It challenges a two percent sequestration cut to Medicare that will take place unless Republicans and Democrats find a way before January to prevent them.
Of course there is a little thing called an election that takes place in November, and both parties are attempting to use the across-the-board sequestration, called for in 2011 Budget Control Act, to their own political advantage. Under that deal, $2.1 trillion will be slashed over 10 years across the entire federal government, including the military.
Of course, when lawmakers cut that deal they did not really expect it to happen. It was simply a way to avoid shutting the government down by failing to extend the debt limit. But to avoid that from happening, a compromise must be reached before year’s end.
The AHCA ad campaign came less than a week after the Office of Management and Budget (OMB) issued a report detailing how federal agencies would implement the $110 billion in mandatory, across-the-board budget cuts for 2013. OMB said “sequestration would have a devastating impact on important defense and nondefense programs.”
Before the report was even issued, the Alliance for Quality Nursing Home Care warned that the U.S. nursing home industry and patients would face sequester cuts of $782 million next year and $9 billion over 10 years. The Alliance also said there would be a total of $65 billion in cumulative Medicare funding reductions over 10 years as a result of numerous budgetary actions and regulatory changes made since 2009, in addition to sequestration.
“With nearly 70 percent of facility expenses related to staffing, the impact of the sequester combined with Medicaid reductions in a variety of states causes significant problems hiring and retaining the direct care staff that help make a key difference in care quality and patient outcomes,” warned Alan G. Rosenbloom, Alliance president.
The LTC industry is not alone in having to face the potential impact on staffing. On September 12, a report was issued by the American Hospital Association, the American Medical Association and the American Nurses Association predicting that those cuts would cause as many as 766,000 health care and health-related jobs to disappear by 2021. The report said an estimated 496,000 jobs would be lost during the first year of the automatic cuts.
The Alliance said the following 15 states would be the most negatively impacted by SNF cuts: California--$75.9 million; Florida--$66 million; Texas--$51 million; New York--$47 million; Illinois--$46.2 million; New Jersey--$37.5 million; Ohio--$37.3 million; Pennsylvania--$36.9 million; Michigan--$30.2 million; Maine--$28.4 million; Indiana--$25.1 million; North Carolina--$22.5 million; Maryland--$18.4 million; Virginia--$18 million; Tennessee--$17.6 million.
Meanwhile, the Alliance said it will continue to spotlight current and future Medicare cuts in states that will make a key difference in this fall’s election. The organization said that in the 12 states that have been the focus of the heaviest cumulative paid media spending in the 2012 presidential campaign, SNF funding would be slashed $251.7 million unless the sequestration across-the-board cuts are rescinded.
“At both political conventions and in a variety of congressional races, issues related to nursing home funding have been part of a vigorous health policy discussion, and reflect the growing importance of replacing what amounts to a ‘cut now and ask questions later’ governmental funding policy with bigger-picture, systemic reforms,” Rosenbloom said. “We will continue to focus state-level attention on cuts to seniors’ Medicare-funded nursing home care that will go into effect less than four months from now, and detail why enacting delivery reforms that reduce costs, improve efficiency and optimize care quality are mandatory, not optional.”
States with the highest sequester-generated SNF Medicare cuts that are also the focus of the heaviest cumulative presidential campaign media spending are Florida, Ohio, Pennsylvania, Michigan, North Carolina, Virginia, Wisconsin, Colorado, Iowa, New Hampshire, Nevada and New Mexico.
Congress is back in session following its summer recess, but time is short because of the election campaign. If history is a guide, a likely scenario would be delay until after the election with the issue taken up by a lame-duck Congress—possibly approaching the Christmas holidays.
Bob Gatty has covered governmental developments for the trade and business press for more than 30 years. He is founder and president of G-Net Strategic Communications, Sykesville, Md.