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Medicaid cuts would hit NJ patients, nursing homes

By: Scott Fallon
NorthJersey.com
USA Today Network - New Jersey

..... Whenever Elizabeth Davis walks the hallways of Bright Side Manor, the Teaneck assisted living facility she operates, she sees the impact of Medicaid money - in a bedroom where an elderly resident rests, in the community area, where bingo is played, and in the dining room, where most residents gather three times each day.
..... About 75% of the home's 65 residents are covered by the government-run insurance program for low-income earned that is lasted for significant cuts in Washington.
..... "Any cuts to Medicaid would devastate us," Davis sad. "We operate on a very slim margin. We fundraiser. We apply for grants. But Medicaid carries us."
..... Respire its being one of the richest states in the nation, Medicaid has become an integrate part of New Jersey's health care landscape. It is used by more than 1.8 million residents for health coverage - from a checkup at the pediatrician, nursing home care and hospital stays to a new pair of eyeglasses.
..... Like anything in health care, those services and equipment do not come cheap. New Jersey's Medicaid program - called NJ FamilyCare - costs taxpayers $34 billion form the federal government and $10 billion in the state's $56.6 billion budget.
..... Republicans in Congress are looking to extend the 2017 federal tax cuts by slashing $2 trillion form the federal budget. Despite tens of thousands of layoffs in recent weeks led by Elon Musk's Department of Government Efficiency, one of the only ways for the GOP to reach that $2 trillion number is by cutting Medicaid.
..... How they plan to do that is not clear, but any large cut could affect swaths of New Jersey residents.
..... Supporters of the cuts argue that Medicaid is a bloated entitlement system that perpetuates a culture of poverty and is ripe for exploitation by those who should be able to find a job that offers health benefits.
..... those opposed, including most health care providers, say it is a well-regulated safety net for some of the most vulnerable in society - including children and elderly residents - by providing essential care and limiting more expensive medical costs in the future."there are really few options for most Medicaid patients,' said Dr, Sara Leonard, president of the New Jersey Academy of Family Physicians. "They can try state marketplace plans, but some might have difficulty with the premiums, other with deductibles and other cost sharing. You're going to end up with a lot of uninsured patients."
..... Hospital executives are especially worried. Not only would they lose some patients on Medicaid, but hospitals would likely see an influx of uninsured patients flooding already crowed emergency rooms seeking charity care.
..... New Jersey Hospital Association CEO Cathy Bennett said the cuts would have a "catastrophic impact." One out of every four hospital patients in New Jersey is on Medicaid, she said.
..... That could add up to billions in lost revenue, according to an analysis by the state Department of Human Services.
..... Large hospital networks, including Hackensack Meridian and RWJ Barnabas, could each see anywhere from $144 million to $650 million in losses, and smaller networks such as St Joseph's Health could face a decline of $35 million, the analysis found.

Infectious diseases

..... Primary care doctors with a large percentage of Medicaid patients are concerned about there bottom line if a sizable portion of the patient base stops coming because they no longer have insurance.
..... But they are even more concerned that patients with chronic illness such as heart disease will no longer be able to afford their daily maintenance medications and visits to their primary care provider. They also fear that infectious diseases could spread much more easily.
..... "If a person with tuberculosis now delays treatment and routinely travels on a crowded bus, that's a scenario that no one wants," said Dr. Steven Levin, medical director of the Eric B. Chandler Health Center in New Brunswick, which sees 200 to 250 mostly low-income patients each day.
..... Levin has seen the benefit of Medicaid whenever one of his many uninsured patients become eligible.
..... "Someone with diabetes now has their blood glucose under control,: he said. "they have medication. They have regular screening. They're no longer going to the ER, because they're not getting as sick as before. It's not theoretical, I see the transformation in front of me all of the time."
..... Dr Michael Ortiz, who has spent the bulk of his career treating the poor in Newark, said the dearth of primary care physicians in New Jersey's inner cities will continue to shrink if enrollment in Medicaid takes a dive.
..... "We prevent, maintain, manage and help people through a health crisis," Ortiz, of Forest Hill Family Health Association. "We keep people out of the emergency room. Take away Medicaid and they're going to the emergency room."

Nursing home care

..... What sets Bright Side Manor apart in the burgeoning world of assisted living facilities is that it will accept Medicaid patients right away.
..... Other homes expect several years of private pay - which can cost $10,000 to $15,00 a month in New Jersey - before a resident can transition to Medicaid because they can no longer pay out of pocket. And even then, only a small percentage of beds are for Medicaid recipients
..... As a result, Bright Side has become a haven for those who cannot afford care elsewhere.
..... Some residents had been low-income earners who were already on Medicaid before they entered Bright Side. But many were part of the middle class and only went on Medicaid when there life savings had run out. In some cases those savings were drained to provide care of a deceased spouse in their final years, Davis said.
..... The vast majority of a resident;s Social Security check and any other income goes toward paying for a bed at Bright Side, with Medicaid picking up the remainder. The demand for assists living, nursing homes and home care is expected to skyrocket in the coming decades as the last wave of the baby boom generation enters the senior years.
..... New Jersey will have 1 million more people over the age of 60 at the end of this decade than at its start.
.... Davis worries about the proposed cuts. She worries that she may have to reduce services. But most of all she worries about her residents, including a 103-year-old man on Medicaid. he's in good shape for his age but cannot live independently. he has family to rely on, no place he can turn to if his coverage is affected, Davis said.
..... "Is this what we really want to do to frail, older adults who had been hardworking, successful members of their community who didn't expect that thaw could live to 85, to 90, to 100?" Davis said.
..... "I don't think any of us want to live in a country," she said, "where we put our older adults onto the street."

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