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Aging in New Jersey and Living on Bonds: Video
“We need to be more thoughtful and creative and committed to caring for people at age-appropriate,” says Elizabeth Davis of Brightside Manor.
Tariq Zehawi and Scott Fallon, Northjersey.com
NJ's Medicaid program has taxpayers $24 billion: $14 billion from the federal government and $100 billion in state budget. Congressional representatives are looking to extend federal tax cuts in 2017 by cutting $2 trillion from the federal budget.
Whenever Elizabeth Davis walks through the hallways of Brightside Manor, the Teenx Assist Living Facilities she runs, she sees the impact of Medicaid money — in the bedrooms where older residents rest, in the community areas, the community areas where bingo plays, and in the dining room where most residents gather three times a day.
Approximately 75% of the home's 65 residents are covered by a government-run insurance program aimed at low-income people, which is expected to be significantly reduced in Washington.
“Medicaid cuts will destroy us,” Davis said. “We operate with a very slim margin. We raise funds. We apply for grants. But Medicaid is carrying us.”
Despite being one of the richest states in the country, Medicaid has become an integral part of New Jersey's healthcare environment. From pediatricians, nursing home care, hospital health checks to new pairs of glasses, it is used by over 1.8 million residents for health insurance.
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Like everything in healthcare, these services and equipment don't get cheap. New Jersey's Medicaid program, called NJ FamilyCare, costs $24 billion taxpayers: $14 billion from the federal government and $10 billion on a state's $566 billion budget.
Congressional Republicans are aiming to extend the 2017 federal tax cuts by cutting $2 trillion from the federal budget. Despite tens of thousands of layoffs in recent weeks led by Elon Musk's government efficiency, one of the only ways GOPs can reach $2 trillion is to cut Medicaid.
While their plans to do so are not entirely clear, large cuts could affect the stripes of New Jersey residents.
Advocates of Cut argue that Medicaid is a bloated qualification system that perpetuates a culture of poverty, ripe for exploitation by people who should be able to find jobs that offer health benefits.
Opponents, including most healthcare providers, say it is a well-regulated safety net for the most vulnerable people in society, including children and the elderly, by providing essential care and limiting more expensive medical costs in the future.
“Most Medicaid patients really don't have a choice,” said Dr. Sarah Leonard, PhD, of the Academy of Family Medicines in New Jersey. “They can try out the state's market plans, but there may be some challenges with premiums with deductions and other cost sharing. There will be a lot of uninsured patients.”
Hospital executives are particularly concerned. In addition to losing some patients in Medicaid, hospitals will likely see an influx of uninsured patients raiding already crowded emergency rooms in search of charity care.
New Jersey Hospital Association CEO Kathy Bennett said the cut would have a “devastating effect.” One in four New Jersey patients take Medicaid, she said.
According to an analysis by the state's Department of Human Services, it could lead to billions of revenue losses.
Large hospital networks, including Hackensack Meridian and RWJ Barnabas, can see losses of $144 million to $650 million, respectively, while smaller networks such as St. Joseph's Health could face a decline of $35 million to $188 million.
Infectious diseases can spread more easily
Primary care physicians with the majority of Medicaid patients are worried about revenue if a significant portion of their patient base stops because they are not covered by insurance.
However, they are even more concerned that patients with chronic diseases such as heart disease will no longer be able to buy daily maintenance medications and visits to primary care providers. They also fear that the infection can spread much more easily.
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“If someone with tuberculosis delays their treatment and travels on a daily basis on a busy bus, that's a scenario no one wants,” says Dr. Stephen Levin, medical director at Eric B. Chandler Health Center in New Brunswick.
Levin has seen Medicaid benefits every time one of his many uninsured patients qualifies.
“Diabetics now have blood sugar control,” he said. “They have medicines. They have regular screenings. They aren't as sick as they used to, so they don't go to the ER anymore. It's not theoretical. I'm always watching transformation in front of me.”
Dr. Michael Ortiz, who spent most of his career dealing with the poor in Newark, said the shortage of primary care doctors in internal New Jersey cities will continue to shrink as Medicaid registrations jump.
Ortiz of Forest Hill Family Health Associates said: “We're keeping people away from the emergency room. If we take Medicaid, they go to the emergency room.”
New Jersey's demand for nursing home care surges
What sets Brightside manners apart in the rapidly growing world of assisted living facilities is the immediate acceptance of Medicaid patients.
Other homes expect a number of years of private salaries that could cost between $10,000 and $15,000 a month in New Jersey before residents move to Medicaid. And even so, there are only a few beds for Medicaid recipients.
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As a result, the bright side has become a heaven for those who cannot afford to care for them elsewhere.
Some residents were low-income people who were already in Medicaid before they entered the bright side. But many were part of the middle class and only went to Medicaid when their lives were no longer saved. In some cases, these savings were discharged to provide care to spouses who died in the last few years, Davis said.
Most of the residents' Social Security checks and other income are directed towards paying for beds on the bright side, with Medicaid earning the rest.
As the last wave of the baby boom generation enters the elderly, demand for support for living, nursing homes and home care is expected to surge in the coming decades.
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New Jersey has 1 million more people than its start at the end of the decade.
Davis is worried about the proposed cut. She worries that she may need to reduce her service. But more than anything, she is concerned about her residents, including a 103-year-old Medicaid man. He is in good condition due to his age, but he cannot live independently. He doesn't have any family to rely on, and if his reporting is affected, there's no place he can rely on, Davis said.
“Is this not what we really wanted to do, the hardworking seniors, successful members of our community living with 85, 90, 100 people?” Davis said.
“None of us want to live in the country,” she said, “We put our elderly people on the streets.”
