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What President Obama’s re-election means for the future of long-term care

November 7, 2012
by The Long-Term Living editors
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The re-election of President Obama and the retention of a Democratic majority in the Senate point toward a continuation of current policies and initiatives pertaining to the long-term care (LTC) industry. But control of the U.S. House of Representatives remains strongly with the Republican Party, adding the factor of party-based conflict among the legislature, much like after the presidential election in 2008.

However, the looming deadlines within the 2010 Affordable Care Act (ACA)—including sequestration and the tax increases of the so-named “fiscal cliff” should Congress fail to act by year’s end—mean lawmakers and the President still must work together on a host of challenges in the next two months.

No one can predict how Congress and the LTC industry players will choose to form their conjoined solutions, or how those solutions will affect skilled nursing facilities and other LTC operations, including the extent of the effects on Medicare. Some of the possible compromises already voiced include certain Medicare reductions and perhaps an increase in the eligibility age for beneficiaries from 65 to 67, among other proposals.

Yet, now that the Presidential election is over, many political entities no longer have reason to campaign heatedly against each other on national healthcare issues, leading to hopes of better bipartisan communication and cooperation down the road. “There is intense pressure in Washington to find a solution,” says Bob Gatty, founder and president of G-Net Strategic Communications, Sykesville, Md., and contributing writer to Long-Term Living.The early tone of [post-election] comments from President Obama and House Speaker John Boehner indicates that there may be a possibility of compromise between the [Republican-controlled] House of Representatives and the White House.”

Now that the nation’s voters have had their say, it’s time to return to the hard work of working together on the issues troubling the U.S. healthcare system, says American Health Care Association President and CEO Mark Parkinson, in a statement following the elections. “While we know that the President and our newly elected Congress must find ways to reduce federal spending and fund a wide variety of programs, now is the time to take a hard look at meaningful reforms to solve the issues that face both the Medicare and Medicaid programs. Stable Medicare and Medicaid funding will help ensure America’s seniors continue to have access to high quality long term and post-acute care.”

Leading long-term care organizations also are ready to move beyond the election rhetoric and return to reform initiatives already underway. “I think our course is now known,” LeadingAge President and CEO Larry Minnix told Long-Term Living. “We’re now beyond political posturing. We’ve got to get into actual implementation of [the ACA]. There are models that people are working on that will work.”

AS THE ELECTION DUST SETTLES

The LTC industry has long complained that continuing reductions in Medicare are jeopardizing patient care and that increases in funding are needed to overcome the failure of Medicaid to adequately cover the cost of serving those patients. However, given the pressure to deal with the federal budget deficit, it is rather unlikely that such increases will be approved by Congress.

Post-election frustrations abound among some in the LTC industry, a care sector that gets a huge amount of its reimbursements from Medicare.  William V. Day, president of St. Barnabas Health System in Gibsonia, Pa., says he’s worried that as many as 50 percent of hospitals and nursing homes will close because of Medicare cuts. “Both parties project that $716 billion will be cut from Medicare to use in Obamacare,” he told Long-Term Living. “I doubt that older Americans realize the impact Obamacare will have on their lives and their health in the future.”

Day views the re-election of President Obama as a great victory for those in favor of increased government control of healthcare: “Regulations and inspections in the healthcare delivery system will be dramatic over the next four years,” he predicts.

The LTC space should prepare for more regulatory activities, agrees Caroline J. Berdzik, Esq., partner, Goldberg Segalla LLP. “We will continue to see more rule-making from the Department of Labor, OSHA and EEOC that will negatively impact nursing homes and result in increased labor costs and additional employment litigation defense costs,” she says.

Berdzik also suggests that “a flurry of regulations under the ACA will be issued to gear up for 2014, and operators will need to pay very close attention, as these regulations will impact areas such as compliance, increased transparency disclosures and background checks of employees. It is highly unlikely that ACA will be repealed now, so operators will have to strategically prepare for these changes and also evaluate, if they have not done so already, how this will affect health insurance offerings to their employees. You may have employers looking to significantly reduce hours of employees to avoid increased health insurance costs. However, any proposed action will need to be analyzed in conjunction with maintaining excellent quality and continuity of care.”

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