Local view: Nelson deserves praise on Medicaid stance

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By Pat Snyder and Bruce Yarwood

When it comes to Nebraska citizens’ growing long-term care needs, cuts to Medicare-financed nursing home care, such as those being persistently pursued by the Bush administration, represent a clear and present danger to the health, well-being and quality of life of our growing retiree population.

If the administration’s regulatory-driven Medicare cuts go into effect later this summer, as planned, Nebraska seniors stand to lose more than $4.7 million in essential health benefits in the year ahead, according to a new state impact study by the American Health Care Association (AHCA), based in Washington, D.C.

This health funding is vital, and not only strengthens facility staffing programs, but also helps improve care quality for the high acuity patients increasingly prevalent in facilities throughout Nebraska, especially in high populated Douglas and Lancaster counties.

To Sen. Ben Nelson’s great credit, he resisted enormous pressure from the Bush administration and took a major bipartisan leadership role in Congress to stop these cuts from going into effect. Working with Sens. Kent Conrad, D-N.D., and Norm Coleman, R-M.N., Sen. Nelson recently joined a letter to the Nebraska Department of Health and Human Services Secretary Mike Leavitt, whose agency oversees Medicare regulations, urging a halt to the regulatory changes.

Their joint letter warns that the senators are “deeply concerned that high-quality, skilled nursing care for America’s seniors will be threatened — and reductions in spending of this magnitude would severely alter not only the quality of nursing home care, but also access to nursing home care for our nation’s seniors.” The letter also references AHCA’s finding that the Medicare cuts will hurt our state economy and cause Nebraska to lose $11.3 million in total economic benefits and $5.2 million in lost wages.

Objectively, the looming Bush Medicare cuts represent a “lose-lose” proposition to Nebraska — not just because seniors’ care needs will be shortchanged — but because the state economy will be damaged at a time we can least afford it. Governors across the nation, including Gov. Heineman, are contending with more difficult state budget conditions associated with the national economic downturn. This has placed enormous pressure on state eldercare programs funded by Medicaid. This is certainly the case in Lincoln. It is widely known that Medicaid payments for long term care are woefully under the actual cost of care. Sen. Nelson knows cutting Medicare at the margin without addressing the huge underfunding for Medicaid residents will put Nebraska’s high-quality care in nursing homes at risk.

Furthermore, existing Medicare policy, as intended, is currently helping facilities throughout the state successfully serve higher acuity patients — at a lower cost than other care settings. Current Medicare policy, according to an independent analysis by Avalere Health, LLC, saved Medicare a substantial $709 million in 2006. In the final analysis, the administration’s ill-considered change to Medicare policy would have unfortunate and unintended results both for patients and for the Medicare program itself — including diminished care for seniors and higher costs for taxpayers.

Fortunately, Sen. Nelson recognizes on an independent, informed basis that the looming Medicare cuts are, plain and simple, bad policy that should not go into effect in the weeks ahead. Despite the pressure to support the administration’s Medicare initiative, the senator deserves strong praise and recognition for putting Nebraska first.

Pat Snyder is president and CEO of the Nebraska Health Care Association (NHCA) in Lincoln. Bruce Yarwood is president and CEO of the American Health Care Association (AHCA) in Washington, D.C.