GLASGOW — U.S. Rep. Brett Guthrie, R-Bowling Green, visited NHC Healthcare Friday morning, answering questions about the new federal healthcare bill.
The congressman met with Denise Billingsley, administrator of NHC, plus several of the facility’s department heads.
One of the first questions Billingsley had for Guthrie pertained to Medicaid and possible cuts to the program. She explained the nursing facility is paid $155 per day per Medicaid resident to provide 24-hour care.
“That provides all medications, meals and everything,” she said. “If our funding is cut, there is no way we can continue (to provide that care).”
Guthrie explained the new federal healthcare bill does not call for cuts in Medicaid, but rather reestablishes the baseline at 2016.
“Currently, we spend as a nation $600 billion on Medicaid, which is larger than any other healthcare service. As a matter of fact, Medicaid is the largest healthcare service in the world. It could go to $1 trillion,” Guthrie said.
He continued there is a lot of misinformation being circulated about the new federal healthcare bill.
“What we are saying is let 2016 be the baseline … and then it grows at CPI (consumer price index) medical plus 1 percent,” he said, adding that the 1 percent was included due to the demand on healthcare from the retiring Baby Boomer population.
The Affordable Care Act enacted during former President Barack Obama’s tenure doesn’t adjust for the retiring Baby Boomer population, “… but ours actually does adjust for that.”
Billingsley also shared with Guthrie a concern regarding labor.
“We are facing such pressure from a labor standpoint. Our local McDonalds, … Akebono, one of our bigger factories here, they are advertising all the time on the radio, ‘you come and can start today for $13.50 or something.’ We currently start our CNAs at $9 per hour,” she said.
Guthrie asked if that was all the nursing facility could afford, and Billingsley said yes, but added that other area nursing facilities recently increased their starting pay to $10 per hour.
“And you get no adjustment in your Medicaid to counter that?” Guthrie asked.
“Exactly,” Billingsley said.
She also pointed out that there is a shortage of qualified people to work in the area.
Guthrie said he understood and knows that for some people it is better for them to be unemployed and maintain their Medicaid healthcare coverage than it is to go to work and risk losing their healthcare coverage.
“Even if you have health benefits at a job, even at Akebono at $13 per hour, it’s tough to go take that job if you lose your health benefits, so what we are allowing is if you are at 138 percent poverty, you get Medicaid, and if you are at 138 percent plus $1, you don’t,” Guthrie said.
Billingsley said she feels there needs to be some sort of graduated process and Guthrie said that is why there needs to be a step down.
“That’s what we hope to do with Medicaid,” he said.
With the new healthcare bill, Medicaid will have two roles. One is traditional in that it will continue to serve the elderly. The other is for those who are disabled.
“Then there is the population you are talking about that could work, but they don’t work because they get trapped,” he said. “That’s what under Obamacare logic called the expanded population. We’re trying to fix that.”
One way the federal government is addressing that issue is to allow Medicaid to operate more like health insurance, he said.
Billingsley also talked to the congressman about some residents at the nursing facility who came there very ill, but have since recuperated and could leave but they can’t afford it.
“As a Medicaid recipient, they only get $40 per month in cash and there’s no way they can rent an apartment and get utilities and things like that so we turn them back to community living with a limited amount of resources,” she said. “There is nothing available to support them for the first month or two while they are in transition back to our community.”
Guthrie explained such transition programs are actually state-based and not federally-based, but he said he liked her idea and would share it with others.
Billingsley told him she knew there was a home and community-based waiver, which operates as a leg of Medicaid, but said to qualify for it a person must be nursing home eligible and meet the requirement to be able to maintain himself at home.
“That’s becoming more and more of an issue with the aging population and the growing incidence of Alzheimer’s,” she said.
Guthrie said he knew there is a lot of anxiety about healthcare right now, but added Congress is trying to sort through some of those things.
“We understand it’s human begins involved and it’s our lives that are involved,” he said, adding that he and other members of Congress are asking themselves how to make it work so it doesn’t implode and that preexisting conditions are covered.
While many say that preexisting conditions aren’t covered in the new healthcare bill, Guthrie said they are.
“Anybody who has health insurance, who maintains their health insurance (and) doesn’t drop their health insurance, all preexisting conditions are covered,” he said, adding that only in states that have a waiver that allows people to buy insurance after they become sick will they be treated differently.
The new federal healthcare bill also continues to allow children to be covered under their parents’ healthcare insurance policies through the age of 25.
The problem lies with those who turn 26 and suddenly have to pay for their own health insurance. Rather than paying a high health insurance premium each month, those who are 26 would rather pay more of out of pocket for certain healthcare services.
“What’s happening is people are dropping out and so it is making it go up,” Guthrie said, adding the underlying purpose of the new healthcare bill is to get young people back into the marketplace “so they can help subsidize everybody else.”
“The Affordable Care Act did some good things,” he said. “If you sit back and say everything is evil and bad, that’s not accurate.”
But Guthrie said he thinks the Affordable Care Act went too far.
The changes that are being made by Congress to healthcare are not as drastic as people think, he said.
Guthrie talks about health care at nursing facility | News