The waiting game

It’s been a week of high anxiety for the long-term care industry as anticipation builds for the U.S. Supreme Court’s impending decision on the fate of the Affordable Care Act, expected to come down before the end of the month.

Court observers are forecasting the demise of the individual mandate for buying insurance with a pretty decent chance the entire law will be struck down. If the court strikes down the law, LTC facilities could be a big loser, according to a report published this week by Kaiser Health News. Medicaid, which covers 70 percent of nursing home residents, would be greatly expanded under the health law, adding 17 million more people starting in 2014, Kaiser reports. But if the law is invalidated, states would be free to tighten eligibility and make application much more difficult.

If the court declares unconstitutional just the law’s expansion of Medicaid, the entire program could be threatened. Twenty-six states have filed suits against the expansion, arguing it was “unduly coercive” because they would forfeit their federal funding if they refused to expand the program, Kaiser reports.

“Depending on how sweeping and broadly written the decision is, it could be the entire Medicaid program has been unconstitutional since 1965, but we didn’t know it,” said Sara Rosenbaum, a health policy professor at George Washington University, in the Kaiser report.

Regardless, sweeping changes to the healthcare system are here to stay, say LTC experts. In an email exchange with William Day, president, St. Barnabas Health System, Day wrote, “Some us are doing something seemingly outrageous. We are ignoring Obamacare. Why? No matter how the nine Supreme Court Justices rule, healthcare reform is here.”

Patricia Sheehan

Patricia Sheehan was Editor in Chief of I Advance Senior Care / Long Term Living from 2010-2013. She is now manager, communications at Nestlé USA.