Commentary: We Need Our Lawmakers to Adequately Fund Medicaid

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People are waiting too long in emergency rooms statewide and hospital beds are in short supply. Low state Medicaid funding is a big reason why. 

In our medical system, when people have been treated in the emergency room or in the hospital, many can then be discharged into skilled nursing or assisted living facilities. But when state Medicaid funding does not cover the cost of care in skilled or assisted living facilities, those patients who could be moved from the hospital have to stay longer, backing up the emergency room and preventing more people with urgent, unmet medical needs from getting a hospital bed. 

I am the administrator of Morton Heritage House and our facility is home to 43 senior residents. The amazing care staff are here because they have a genuine heart for the hard but rewarding service they provide on a daily basis. They came to work every day at risk to themselves during COVID because they see their work as a calling to care for people in need. 

Washington is probably the most aggressive state in the nation in regulating long-term care settings, including assisted living homes like ours. We want what the state wants: safety and good care for our residents. They deserve it. What’s wrong is that the state does not match the high level of regulation with adequate funding. In Oregon, the state pays 100% of the cost of care for Medicaid residents, but in Washington state, it’s only 68%. The costs for staffing, for groceries, for electricity are going up all of the time. The combination of low funding and higher costs puts people at risk.

What’s the human cost of that underfunding? Longer waits for everyone in the ER. Hospital beds being occupied by people who should be discharged into skilled nursing or assisted living homes like ours. There is also a cost to taxpayers because it is much more expensive to keep a patient in the hospital than in assisted living or skilled nursing. 



We work with people hoping to live here. We try very hard to be able to accept them even though, likely, within a few months they will require Medicaid funding. We will accept them because we feel the need to help people despite the fact the state will not pay enough to cover the level of care and staffing that is required. No business can afford to keep doing this for very long. 

There is a human cost to this also. Our residents are from this area. This is their home and in most cases, families live nearby. If state Medicaid funding is not raised, we will face a decision where we will either have to deny admission to Medicaid residents or close the doors on many facilities like ours. Medicaid residents will be forced to move from the area, away from loved ones who provide emotional support.

I know our legislators have a lot on their plates but in our community, our residents and staff and their families are counting on the Legislature to adequately fund Medicaid care for the people who rely on this support.

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Tammi Elswick is the administrator for Heritage House in Morton. She can be reached at tammi.elswick@caringplaces.com.