Proposal by the current White House administration and the Republican-infested U.S. Congress to overhaul the $530-billion Medicaid program will not only send millions of older Americans without access to immediate and direct help with their activities of daily living, it’s also expected to render millions of nursing home workers unemployed.
Medicaid’s second largest expense is care for the elderly—who comprise only 9 percent of program enrollees but account for 21 percent of its spending, according to a report by TIME. “Much of those costs go to long-term care, which Medicare generally does not cover.”
In its present form, the federal government funds 57 percent of Medicaid’s overall expense, with the states taking care of the remaining 43 percent—with no fixed dollar limit. Trump and his U.S. Congress allies are proposing to convert the federal government’s Medicaid funding into block grants—a form of funding with fixed dollar limit.
TIME acknowledged that while block grants would “give states more flexibility, [it] typically doesn’t keep up with rising costs.”
Currently in California, Medi-CAL reimbursement rate for a day’s stay in a skilled nursing facility is about $192. A portion of this cost is paid for by nursing home residents’ own resources, including Social Security pensions.
If and when the Republicans’ plan to radically change the Medicaid program goes through, older Americans who don’t have the financial capability to pay for their share of cost in a nursing home stay would be forced out of the facility to live either in a home without care and assistance with their activities of daily living or—since many of them are homeless—in the streets.
Lack of funding for nursing home stay for the elderly would also eventually force skilled nursing facilities out of business, potentially displacing millions of health care workers across the nation. The Bureau of Labor Statistics estimates that there are over 3.3 million nursing home and residential care facility workers in the U.S. as of January 2017.