Seniors “Heart” Ryan, But His Budget Would Probably Slash Nursing Home Payments

Now that Representative Paul Ryan (R-Wisc.) has been tapped as presumed GOP presidential candidate Mitt Romney’s running mate, there’s an uproar about his budget proposal, which includes extensive changes for the Medicare program, including the introduction of a voucher system for seniors to purchase private health insurance plans. 

Ryan’s budget would drastically change how Medicare is structured and it would impact Medicaid, too, but many seniors—for now, at least—support the Wisconsin congressman, according to a Washington Post-ABC News poll which showed half of the 65+ crowd viewing Rep. Ryan favorably. 



Credit: Washington Post-ABC News, 2012

“The numbers suggest Democrats’ attempts to turn Ryan’s Medicare proposal against the GOP haven’t stuck yet among the most pivotal group: seniors,” writes the Washington Post. “If a Medicare attack was working, after all, seniors would likely be the first group to start deserting Ryan.”

With most of the fuss focused on Medicare, not too much attention has been given to Ryan’s proposal to revamp parts of the Medicaid payment system.


A Politico article explains:

While Paul Ryan’s Medicare plan is getting all the headlines, his plan for Medicaid is every bit as dramatic. But because Medicaid helps the poor—who don’t vote—rather than seniors—who do—it hasn’t dominated the presidential race like Medicare has.

Ryan’s budget would turn Medicaid into block grants to the states. That’s not a new idea; Republican governors have been demanding that since at least the Reagan years, which is another reason the issue isn’t capturing the headlines right now.

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But Ryan’s plan delivers: It would reduce growth in Medicaid spending by $800 billion in a decade and repeal the Medicaid coverage expansion under the Democrats’ health care law.

Ryan’s “massive cuts,” Joe Biden said on the campaign trail this week, “could throw 19 million people in distress off of Medicaid, including 1 million seniors, roughly 75 percent of whom are women. How do they think these people in nursing homes are there? Who do they think pays for that? Seventy-five percent of those octogenarians, those elderly—I mean genuinely elderly—persons in homes, they’re there because of Medicaid,” he said.

Forbes contributor writes:

The joint state/federal health program for the poor is also the nation’s largest single payer of long-term care services. One third of its budget–or $120 billion–goes to long-term care.

Today, the federal government pays just under 60 percent of all Medicaid costs, and in some states it pays more than 70 percent. As Medicaid costs rise, the federal payment automatically increases. But Ryan would end that system. Instead, the feds would decide each year how much to spend on Medicaid and send those dollars to the states as a block grant. States would get much more flexibility in running their programs, but they’d also get lots less money.

The Congressional Budget Office projects Ryan’s plan would reduce federal Medicaid spending by $800 billion over the next 10 years. By 2040, federal spending for Medicaid would be cut in half. As a result, Medicaid-funded long-term care services would be forced to compete for shrinking resources with health programs for poor children and their mothers. Nursing home payments would be slashed, home care would be limited, and the level of services would be vastly different from state to state.

Ryan’s plan could also bear implication for non-Medicaid services such as transportation, meals, information services, and affordable housing for seniors, says Forbes, as many of these programs are already under pressure. 

For now, at least, says the Washington Post, the Republican’s plan for the Medicare program isn’t scaring seniors away.

Written by Alyssa Gerace