Use Medicaid stimulus funds to help seniors

Use Medicaid stimulus funds to help seniors
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USE MEDICAID STIMULUS FUNDS TO ENHANCE PENNSYLVANIAN'S HEALTH CARE


By Stuart H. Shapiro, MD
President and CEO
Pennsylvania Health Care Association

Pennsylvania will receive nearly $4 billion in additional federal Medicaid funds over the next 22 months as part of the American Recovery and Reinvestment Act of 2009.
Inclusion of these funds in the stimulus package is in response to pleas from the National Governors Association, chaired by our own Governor Ed Rendell, calling on Congress to help states preserve access to health care for children, struggling families, the disabled and the elderly.
Now that the stimulus funds have begun arriving, Governor Rendell and state lawmakers should use those funds --- as well as already pledged state Medicaid dollars --- to shore up and preserve a fraying safety net that cares for Pennsylvania's neediest residents, starting with the elderly.
In trying economic times, limited funding must be targeted where it is needed most, and nothing can be more important than caring for our most vulnerable populations.
Some governors have stated that they plan to use state funds originally slated for Medicaid to plug other budget holes instead, now that additional federal Medicaid dollars are on the way. But Pennsylvania cannot afford to follow that lead. Our state is already on the verge of a fiscal tsunami when it comes to caring for the elderly, as we are among the nation's oldest and most rapidly aging states.
By the very nature of most social programs, demand for services increases when times are tough. We already know that the number of uninsured adults is rising as hardworking Pennsylvanians are losing their jobs and, hence, their health insurance. The number of people who qualify for Medical Assistance is increasing, and will continue to increase in the months, even years, ahead.
Despite the robust growth of home and community care for seniors and the disabled over the past few years, the need for these vital services also continues to grow.
As acting Secretary of Aging Mike Hall told a reporter last week, the Governor's flat funding of senior services in his proposed 2009/2010 budget is recognition that demographic shifts are only going to increase the need to assist the older population. But flat funding does not mean these programs are held harmless. The cost for delivering care continues to rise.
Nursing homes are in a particularly difficult situation, as they are the health care provider most impacted by the chronic Medicaid under-reimbursements that plague Pennsylvania. Two out of three nursing home residents are on Medicaid, and for each one of them, the cost of care exceeds the cost of reimbursement for that care by $14 a day, or $5,000 a year. And that gap grows wider each year.

A report from the Pennsylvania Hospital and Health System Association revealed that between 42 percent and 68 percent of hospitals, depending on their location in the commonwealth, have indicated they are finding "capacity for skilled nursing care an impediment to timely and appropriate discharge of patients to post-acute settings" problematic or very problematic. This is driven, in significant measure, by low Medicaid reimbursement for nursing homes.

Since Medicaid is a state and federal match program, the more state money that is invested in health care, the more federal money flows into our commonwealth. And at a time when many hardworking families and seniors are finding themselves in desperate economic situations, it is vital that Pennsylvania preserve access to health care and health services. Our economy will never be strong if our residents are weak.

There are still enormous challenges ahead, and we recognize the difficult tasks Governor Rendell and the legislature face. But health-care money should be used for health-care purposes. Anything less puts at risk those who need help the most.

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