Not 100% sure how to interpret this, will update soon.
In what some are calling the “decision of a century,” the Supreme Court ruled today to essentially uphold the Affordable Care Act, including the provision that is arguably the most relevant to the skilled nursing industry: Medicaid expansion.
“The bottom line: the entire ACA is upheld, with the exception that the federal government’s power to terminate states’ Medicaid funds is narrowly read,” said the site publisher of the SCOTUS blog, Tom Goldstein, minutes after the ruling.
The health care reform provision to expand Medicaid eligibility and coverage is probably the biggest aspect of how health care reform will directly impact the skilled nursing industry, says Greg Crist, vice president of public policy at trade group the American Health Care Association (AHCA).
Eligibility for participation in the Medicaid program has been expanded to cover nearly all non-disabled adults younger than age 65 with household incomes at or beneath 133% of the federal poverty level — for about 17 million new beneficiaries — starting in January of 2014.
Medicaid has been expanded before, but under the ACA, funding is going to be slightly different, says Kaiser Health News: “The ACA provides that the federal government will not cover its normal share, but rather 100% of the states’ costs of the coverage expansion from 2014 through 2016, gradually decreasing to 90% in 2020 and thereafter.”
Led by Florida, 26 states filed a lawsuit against the Department of Health and Human Services challenging the ACA’s Medicaid expansion provision, saying it was “unconstitutionally coercive of states,” says the Kaiser Health News brief.
If states are unhappy with the direction Medicaid is headed in, they can just opt out — it’s a voluntary program. For many, though, it’s not that easy. All states currently participate, and they depend on the federal matching funds to cover the costs of services to eligible individuals, including about 60% of the nursing home population.