Society Opposes Better Care Reconciliation Act

AMDA – The Society for Post-Acute and Long-Term Care Medicine strongly opposes the Better Care Reconciliation Act, H. R. 1628 (BCRA of 2017). The Society believes this legislation does not address and only worsens concerns expressed in response to the American Healthcare Act (AHCA) passed by the House of Representative earlier this year.

The Medicaid provisions of this bill will be detrimental to millions of older adults, many of whom are veterans, who require post-acute and long-term care (PALTC). Cuts to federal Medicaid funding through either per capita caps or block grants, phasing out and then completely eliminating the requirement that Medicaid cover essential health benefits (EHBs), will be harmful to the nation’s most vulnerable population. Data published by the Kaiser Family Foundation show that some 64 percent of nursing home residents rely on Medicaid for their coverage. Medicaid is the primary payer for long-term care in the U.S., and in 2014 about one third of Medicaid spending was on long-term care services.

Our nation’s seniors, including veterans, who receive services covered by Medicaid are the frailest and most financially vulnerable members of their communities, and a population growing rapidly. They have no other resources to cover the cost of essential services. Their long-term care needs will disappear if they or the services they receive are cut from the Medicaid program. The BCRA threatens custodial, skilled nursing, and community based care, as well as the current federal requirement that nursing home care be covered.

As an organization representing post-acute and long-term care clinicians who take care of millions of elders and other seriously ill and disabled individuals who rely on these services, the Society urges the Senate to carefully consider any such proposals that would put the health of the patients our members treat at risk. Congress must work with stakeholder organizations to introduce legislation that benefits all Americans and ensures quality of care for our most vulnerable population. The Society stands ready and willing to work with Congress to craft such legislation, and protect our nation’s post-acute and long-term care population.