Carma Matti-Jackson: Medicaid funding key to health care access
By Carma Matti-Jackson
Washington’s budget writers are working now to determine funding priorities for the 2023-25 state operating budget. For the long-term care centers we represent – skilled nursing, assisted living and enhanced services facilities – the Legislature’s support for adequate Medicaid funding is central to accessing health care at the hospital and in the community.
Current circumstances are grim. Skilled nursing facility Medicaid rates compensate providers for the same wage levels people were earning in 2020. Goods, utilities, food and supplies are also paid according to what they cost three years ago, even though we’ve had record-breaking inflation since then. The failure to regularly update Medicaid rates has a significant price. During the past five years, over $620 million in uncompensated Medicaid care has been delivered in skilled nursing facilities that struggle to remain viable.
In assisted living, Medicaid reimburses just 62% of every dollar spent on wages and benefits. This has led to a decline in access for low-income seniors who would otherwise receive care in this setting, which includes an apartment, 24/7 support, personal care, medications management, activities, laundry, housekeeping and food services.
Despite the significant staffing and regulatory requirements, enhanced services facility rates are arbitrarily established with no payment methodology to drive funding levels.
A history of Medicaid funding shortfalls in long-term care is having an immediate and ongoing impact on health care services for Washingtonians. We are losing our essential caregiver workforce to retail sales and fast food because funding doesn’t support competitive wages.
Every day, we hear stories about people who could be served in these long-term care settings, but are backed up in the hospital, awaiting discharge because there are no available placements in long-term care settings. This is wreaking havoc on the whole health care system. The inability for hospitals to discharge has required them to operate over capacity. People who need to be admitted for medical care are boarded in emergency rooms and emergency room hallways. All of this contributes to the lengthening wait times when people come to the emergency room for an urgent medical need.
Inadequate Medicaid funding also profoundly affects caregivers in long-term care settings. The long-term care workforce is doing some of the most physically and emotionally challenging work in our society, providing intimate and necessary care and services to support the general well-being of people who truly need care. When funding fails to keep pace with labor costs, these caregivers are asked to do more with less, often at the expense of personal health and well-being.
This is a problem the state Legislature can fix by making a bold and necessary investment in Medicaid-funded long-term care. Adequate Medicaid funding is important to those who require critically important health care , whether in the hospital or other long-term care settings.
Please join me in urging budget writers to consciously and adequately fund Medicaid care and services. At a minimum, these rates should be updated to reflect current labor and operating costs, which have grown tremendously. These are our parents, grandparents and neighbors, and they deserve quality long-term care.
Carma Matti-Jackson, of Olympia, is the CEO of Washington Health Care Association. WHCA represents 160 of 200 skilled nursing centers, 340 assisted living centers, and nine enhanced services facilities in Washington, including several in Spokane.