We are leaving out an entire category of our citizens in the discussion about Medicaid block grants—our seniors and, even if we are currently younger than 65, ourselves as future seniors.
In Tennessee, we who are 65 and older account for 16% of the total population. That number is growing. You may have seen that 10,000 baby boomers a day are turning 65.
About 5% of the people enrolled in TennCare are seniors, and TennCare provides 62% of the nursing home coverage in our state.
These are our fathers and mothers, our aunts and uncles. How do I know that?
Someone turning age 65 today has almost a 70% chance of needing some type of long-term care services. Over 40% of the general population will need eventually to stay in a nursing home. Ladies, that is heavily weighted towards us.
According to the most recent study of long-term care costs conducted by Genworth, in Davidson County, in 2018, a private room at a nursing home costs an average of $90,338 annually; semi-private, $80,300; assisted living $54,000; and health aides/companions about $45,000. Adult day services remain a bargain at just under$17,000 annually.
TennCare is already efficient
As I understand the argument for block grants, they are a way to bring more accountability and flexibility in running the TennCare program.
But, in fact, TennCare has a record of being, according to one expert, a “very efficient program,” perhaps one of the top five states in efficiency.
So when the state says, “it has no intention of cutting, changing who’s currently eligible or what services it covers,” the $2 billion that the state proposes to save must come from somewhere.
Gordon Bonnyman, a staff attorney and co-founder of the Tennessee Justice Center, says this, according to the Chattanooga Times Free Press. “Where [TennCare is] going to get these savings is by cutting benefit levels. They’re not going to eliminate services, but they’re going to cut benefit levels.”
Currently, the state pays $5,472 per month to nursing homes for our spouses, moms, dads, aunts and uncles. That is $1,220 per month below what the average patient pays for a semi-private room, according to the Genworth study.
So where are the cost savings going to come from for our seniors? If you think that nursing homes can cut excess staff, you simply haven’t had any experience with nursing homes lately.
I’m concerned and you should be, too. Our seniors, who have met the guidelines for coverage of their nursing home costs, are at risk.
Barbara J. Moss is founder of Elder Law of Nashville.