Nursing homes, particularly in rural communities, are closing across the state. The residents in these facilities are often forced to move away from family and friends to find a place that will accept them. The problem is Medicaid payments from the state for these facilities are far below what is needed to cover costs. Everyone knows about this problem, and Gianforte proposed a paltry increase while trying to save the rest of the budget surplus to give tax breaks to his rich friends. Problem is it’s too little, too late. Here’s an explanation from Big Sky 55+
First, A Little Math (Don’t Worry, This is Simple)
The current reimbursement rate for Medicaid patients is $208 per patient per day. The current cost of operation for nursing homes is estimated to be at least $279 per patient per day. Bottom line is that the current reimbursement rate is at least $71 a day short of covering expenses. But wait, there’s more! For every $1.00 the state spends for Medicaid expenses, the federal government pays $2.37. Simply put, for every dollar the state “saves” by not funding Medicaid services, it leaves $2.37 on the table. This only makes sense to Republicans.
Gianforte is Supposed to be a Good Businessman!?!?
The last legislature commissioned a study to determine what it would cost to stop the crashing of long term care facilities in Montana. Though the full cost is probably higher depending on the facility, the legislative study recommended a “benchmark” of $279 per day to cover costs. Gianforte’s budget proposed paying 88% of that amount. Last time we checked, any business has to meet expenses to keep its doors open. Doesn’t matter if you cover 88% percent or 95% of your costs, you still go out of business if you can’t cover 100%. But, as we have said before, Republicans don’t understand Economics 101.
Democratic Proposal Passed the House
In response to the obviously inadequate proposal in Gianforte’s budget, Representative Mary Caferro (D-Helena) introduced HB 649, which increased funding for long term care to the benchmark amount. Surprisingly, the bill passed on the House floor and is now on its way to the Senate.
Great Falls Republicans Split on Supporting Full Funding
There are two distinct factions in the Great Falls Republican Party which have been at war with each other for years. One camp is the local Central Committee which is composed of less extreme, corporatist members. The other camp is the tinfoil hat conspiracy crowd which is centered around the local Pachyderm Club. The dominant faction is the Pachyderm Club.
| Corporatist Lackey Republicans for HB 649 | Conspiracy Crazy Republicans against HB 649 |
| Fred Anderson | Steven Galloway |
| Ed Buttrey | Scot Kerns |
| Steve Gist | Lola Sheldon-Galloway, |
| George Nikolakakos |
If the above chart makes you think that the crazy crowd doesn’t run the local Republican Party in Cascade County, we remind you that the crazy Republican office holders in Cascade County include our Sheriff Jesse Slaughter, Clerk and Recorder Sandra Merchant, County Commissioner Rae Grulkowski, and perhaps the weirdest elected official in the state, Randy Pinocci. There has been a lot of news coverage about this split in Cascade County. Here’s just one example.
Hopefully the bill will be well received in the Senate. Montana has a huge budget surplus, and the people in nursing homes are among the most vulnerable in the state. Pushing them out the door is unnecessary and inhumane. Question is, does the Republican Party care?