High anxiety

The winter of our discontent has segued into a spring of high anxiety for long-term care (LTC) recipients and providers (and the general public, for that matter). Congress narrowly averted a government shutdown as it battled over the 2011 budget. House Budget Chairman Paul Ryan issued his 2012 proposal, which would transform Medicare to a voucher system and fund Medicaid with state block grants. President Obama then outlined in his deficit reduction plan how to trim $4 trillion by 2023, with much softer reforms to Medicare and Medicaid. At press time, Ryan’s budget proposal passed in the House.

As LTC advocates scramble to digest these sea-change initiatives and muster lobbyists for battles to come, frustration and uncertainty reign. I saw that for myself while covering last month’s Assisted Living Federation of America conference in Orlando. ALFA President/CEO Richard Grimes offered his take on proposed reforms to Medicare and Medicaid: “I think we’re all worried about what that future holds. Where will people go if the states can’t support themselves?”

LeadingAge President Larry Minnix was blunt in his assessment of proposed budget cuts. On Twitter he posted: “Bad morally and bad economically.” And in an interview with Long-Term Living Editor Kevin Kolus during last month’s Future of Aging Services Conference in Washington, D.C., he added: “We’re incensed about it all, and at the same time know we have to have those discussions. Whatever is going on needs to be grounded in reality, not in ideology. And if you ground it in reality, it can be based on sound principles, not just political gamesmanship.”

Speaking to Ryan’s proposal, Minnix said: “We’ve got some serious concerns about block grants because we think they will lead to lower Medicaid reimbursement for nursing homes…. We believe we can make the case that if you continue to put pressure on Medicaid reimbursement, you’ll make costs in the rest of the healthcare delivery system go up, not down.”

These frank assessments from two of LTC’s leading advocates should be a rallying call for grassroots advocacy from anyone with skin in the game. What will you do to help ensure the future viability of your LTC community?

Long-Term Living 2011 May;60(5):6

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