PROPOSED BUDGET CUTS WOULD COME AT A HIGH COST TO HEALTHCARE FOR OLDER ADULTS

President Bush’s 2008 budget proposal, which aims to eliminate the deficit by 2012, calls for unprecedented cuts in Medicare and Medicaid funding that would create enormous obstacles for long-term care facilities.

All told, proposed cuts in funding for the programs would total more than $101 billion over five years. More than a third of these cuts would come from limits on annual inflation adjustments for reimbursements to nursing homes, hospitals, and healthcare providers caring for beneficiaries. While the President has proposed similar cuts in the past, he’s now calling for permanent cuts that would keep nursing homes, as well as hospitals, from getting full adjustments for inflation.

As is, many long-term care facilities are struggling to deliver quality care to older adults. Healthcare workers trained to care for older adults are already in short supply, and proposed cuts in provider reimbursement would only exacerbate workforce problems. Not only would the President’s budget plan cut reimbursement to healthcare providers by 0.65% next year, it would trigger another 0.4% cut in payments to providers who fail to submit quality and price information after 2008. In addition, it would cut reimbursement by yet another 0.4% whenever Medicare general revenue exceeds 45% of the total cost of the program.

Further undermining efforts to boost recruitment into geriatrics healthcare professions, the proposal would eliminate funding for most Title VII programs, including Geriatrics Health Professions Programs that provide training to professionals and healthcare for older adults.

These changes would, of course, come at a tremendous cost to older Americans. Not only could they further curtail older adults’ access to physicians (an increasing number of whom are weighing whether to continue accepting new Medicaid patients) and other healthcare providers, they would also threaten access to long-term care facilities.

Fortunately, President Bush’s plan is far from a fait accompli. A final budget will be months in the making, and the Democratic majorities in the House and Senate make it unlikely that the spending plan assembled on the Hill will closely resemble the President’s proposal. In a bipartisan effort the day after the President proposed his budget, Reps. Richard E. Neal (D-MA) and Phil English (R-PA) were already asking their colleagues to sign a letter opposing any reductions in Medicare payments to hospitals.

“His budget hands out favors for the oil and gas industry, while eroding health coverage for children and seniors,” Senate Majority Leader Harry Reid (D-NV) told The Wall Street Journal, referring to additional provisions in the President’s plan that would benefit the energy sector but provide less than half the additional funding that the Children’s Health Insurance Program would need to continue providing existing coverage.

While Congress deliberates, we need to advocate—for adequate funding for healthcare for older Americans. We’ve done it before, and succeeded. In the wake of concerted advocacy campaigns organized by the American Geriatrics Society, its members, and others committed to quality care for older people, Congress blocked a mandated 5% cut in physician reimbursement last December. As this issue of Annals of Long-Term Care went to press in mid-February, Congress was poised to pass a continuing resolution (CR) restoring funds for Geriatrics Health Professions Programs this fiscal year. After funding for the programs was eliminated last fiscal year, AGS, its members, and others launched a year-and-a-half-long campaign advocating the restoration of funds.

Sources in Washington recently told AGS that Congress plans to use the level of funding that the CR earmarks for Title VII programs this year as a base and intends to increase funding for the programs in fiscal year 2008. Clearly, many legislators have different priorities than the President.

AGS and its members will also play an active role in advocacy aimed at ensuring adequate support for healthcare for older adults in 2008. Visit www. healthinaging.org/advocacy to join our efforts.