Some people continue to debate the impact of the economic stimulus package passed by Congress and enacted by President Barack Obama in 2009. However, in my opinion, there is no debate that the parts of the law that protected the health and long-term care of people most in need made a profound and positive difference in many lives. That positive difference may soon turn into damaging and painful reductions in the resources that our elders, families and people with disabilities depend upon.
The stimulus act, known officially as the American Recovery and Reinvestment Act of 2009, included a temporary increase in the Medicaid Federal Medical Assistance Percentage (FMAP) so state governments could ensure that the most vulnerable citizens and those who are unable to provide for their own health or long-term care could in fact receive the care they needed.
More than 30,000 of Maryland's elderly and disabled residents receiving long-term care benefited a great deal from the enhanced federal funding that boosted our state's ability to provide quality long-term health care. In addition, 63,000 low- and moderate-income adults — parents of children who were already covered by Medicaid but who themselves were without health care before Maryland's expansion in 2008 — also benefited from the earlier increase in FMAP. Without that funding, state budget cuts would have gone much deeper.
In the coming days, Congress will consider extending this critical funding. Failure to do so would put people at great risk — especially in states such as Maryland, which have budgeted assuming this extension. Seniors and people with disabilities risk losing access to their only safety net for care; low-income parents risk losing their only option for health care coverage; and thousands of good front-line health care jobs are in jeopardy. Congress must act immediately to extend the enhanced federal funding to aid states facing tough economic times and massive budget challenges.
What is at stake in Maryland? Nearly half a billion dollars ($474.9 million in federal funds). Now, more than ever, we need the Maryland congressional delegation to help get this done and rally their colleagues in Washington to pass the extension. These federal funds have made a significant difference — especially in light of more than $180 million in state funding cuts over two years to long-term-care Medicaid.
As the bipartisan National Governors' Association notes, "Funding for FMAP is a particularly effective tool because it immediately allows governors to eliminate planned budget cuts required to meet balanced budget requirements and continue services for those with the greatest need."
Gov. Martin O'Malley, who has effectively navigated a sea of red ink, well understands that the temporary FMAP increase is vital. While we are perhaps turning a corner in terms of the economy, it remains clear that Marylanders who so needed the help of the FMAP extension to ensure quality care still need that care.
Beyond the moral imperative of assisting individuals and families in desperate need, there is a national economic argument to be made in favor of extending FMAP. In a time when job creation has lagged, the long-term care provider community created 50,000 new jobs in 2009. This industry employs 3 million people with wages of $93 billion and contributes to an additional 1.5 million related jobs — amounting to more than 1 percent of the nation's total gross domestic product.
Here in Maryland, the economic argument for the FMAP extension is also strong: Maryland's 230 skilled nursing facilities employ more than 34,000 people and have a direct state economic impact of $3.7 billion and an indirect impact of $6.1 billion through real estate, finance, insurance, retail and scientific/technical services industries. Without this $474.9 million in federal funds, nearly 9,000 Maryland jobs related to long-term care and $1 billion in state economic activity are lost.
Together, we must double our efforts to deal with the tough issues of the funding of health and long-term care in the future; to better educate consumers of all ages so they can better prepare for participating in their health care and long-term care; and to promote quality outcome measures for all care.
Congress must act — now — to extend enhanced federal funding to aid states and help people most in need.
Joseph DeMattos Jr. is president of the Health Facilities Association of Maryland, a voluntary provider community association that is Maryland's oldest and largest long-term care association representing skilled nursing, sub-acute facilities and assisted living programs. His e-mail is jdemattos@hfam.org.