Skilled nursing operators looking for relief in Senate Republicans’ bill to repeal and replace the Affordable Care Act (ACA) won’t find it in the latest version, released Thursday.
Several major amendments have been made to the Better Care Reconciliation Act (BCRA or Better Care), but the new draft bill still contains deep cuts to Medicaid funding over the next decade, which will likely have significant impacts on SNFs.
Medicaid Funding Worries
The biggest uproar about the Republican plan originated from its deep cuts to Medicaid, which were estimated to top $800 billion over a span of about 10 years. The new version maintains major cuts to the federal program, and also includes fundamental changes to Medicaid financing as written in previous versions.
Cuts to Medicaid could have a great impact on the skilled nursing sector, including shifting dollars away from providers and residents overall. Estimations show that more than 60% of seniors in nursing homes are reliant on Medicaid, according to the Kaiser Family Foundation.
The American Health Care Association (AHCA) estimated that individual SNFs would lose as much as $600,000 in funding per year by the 2030s under the Senate’s first version of the bill, which also included Medicaid cuts.
Changes and Amendments
Some of the biggest changes in the new version of the bill include what is being dubbed “the Cruz Amendment,” which essentially enables insurance companies to offer lower-cost plans with less coverage by eliminating the essential health benefits requirement in the ACA. The amendment was put forth by Sen. Ted Cruz, a Texas Republican and former 2016 GOP presidential hopeful.
The bill also includes $45 billion to aid the opioid addiction crisis that has taken hold in several states, and $70 billion in additional funding to help Americans pay for insurance plans. The new draft keeps ACA taxes in effect.
Senate Majority Leader Mitch McConnell, a Kentucky Republican, is determined to pass an Obamacare replacement plan; he even stated that the Senate would remain in session instead of breaking for a long, two-week recess in August.
At least two Republican Senators — Rand Paul of Kentucky and Susan Collins of Maine — said they were still “not swayed” enough by the bill’s changes to confirm their votes, the New York Times reported. Republicans need at least 50 votes to pass the bill, with Vice President Mike Pence casting the tie-breaking vote in affirmation. The party currently holds 52 seats in the Senate, and can thus only afford to lose two votes for the bill to pass.
The bill is expected to come to a vote next week. However, scheduled votes on the bill have been scuttled before, including one just prior to the July 4 holiday.
Written by Amy Baxter