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Del. Mark Sickles, D-Fairfax, says increased demand for nursing home care is a major reason why the Virginia’s Medicaid costs have soared.
"We’re living longer than ever and you have to spend down until you get to $2,000 of assets before you qualify for (Medicaid funded) nursing home care in our state," Sickles said in a recent floor speech. "$2,000. That’s where the money goes. That’s where 70 percent of the money goes in our Medicaid program – to help our seniors live with skilled nursing who need it."
Let’s start by noting that Sickles is correct is saying that Virginia’s Medicaid will only pay for nursing home care to elderly and disabled people whose total financial resources don’t exceed $2,000.
What we want to explore in this Truth-O-Meter is Sickle’s claim that 70 percent of the state’s Medicaid money goes to provide elderly care in nursing homes. The statement comes amid a partisan battle over whether expand Medicaid to up to 400,000 additional low-income Virginians. Under Obamacare, the federal government would always pay at least 90 percent of the tab.
The GOP-led General Assembly blocked the expansion last month, saying Washington can’t be trusted to pay its promised shares. Gov. Terry McAuliffe, a Democrat, is exploring whether he can broaden the program without legislators’ consent.
Sickles told us he can’t recall the exact source of his nursing home claim but, as a long time member of the Health, Welfare and Institutions Committee, he’s often heard that 70 percent of the Medicaid money goes to 30 percent of the recipients. He said he understood that trend was "largely caused" by seniors in nursing homes.
But Craig Markva, a spokesman for the Department of Medical Assistance Services, which runs the state’s Medicaid program, gave us a different explanation. He said 70 percent of the money is spent on the medical expenses of all elderly and disabled patients, who comprise 32 percent of Virginia’s Medicaid recipients.
Markva sent us Medicaid statistics for the budget year that ended June 30, 2013 -- the latest numbers available. They show that of the slightly more than 1 million Medicaid enrollees in Virginia, only 22,513 -- or 2.2 percent -- were seniors in nursing facilities.
Out of a $6.7 billion Medicaid budget that fiscal year, the state spent $648 million to care for seniors in nursing homes. That boils down to 9.7 percent of the money.
All told, seniors accounted for about 7 percent of Virginia’s Medicaid recipients during the 2012-13 budget year and received about 17 percent of the funds, or slightly more than $1.1 billion.
Sickles said that 70 percent of the state’s Medicaid spending goes to seniors in nursing homes. He’s way off; only 9.7 percent of the money goes to that cause.
We rate his statement False.
Del. Mark Sickles, floor speech, June 23, 2014.
Sickles, telephone interview, June 25, 2014.
Emails from Craig Markva, spokesman for Department of Medical Assistance Services, June 26 and July 9, 2014.
Department of Medical Assistance Services, "Nursing facility admission," accessed July 8, 2014.
DMAS, "Virginia Medicaid at a Glance," accessed July 14, 2014.
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