Texas Senate Votes For Nursing Home ‘Quality Insurance’ Fee to Increase Federal Medicaid Funding

The Texas Senate on May 10 passed a bill (SB 1839) that would use a "quality assurance" fee to raise funding for nursing homes by an estimated $186 million next fiscal year, the Dallas Morning News reports. Under the provision, nursing homes would be charged $5.25 a day for each occupied bed. This revenue would draw increased federal Medicaid matching funds. The new money would be distributed to homes with "at least" 28% of their residents receiving Medicaid benefits. About 1,054 facilities in the state would receive increased funding under the system, while 83 homes would not (Stutz, Dallas Morning News, 5/11). Critics of the bill dubbed it the "granny tax" and said the fee would be passed onto consumers who are "already struggling" to pay for the increasingly expensive care. The bill also requires the state insurance commissioner to develop plans for nursing homes to improve care and "minimize hazardous conditions" and allows for-profit facilities to obtain liability insurance through the Joint Underwriting Authority, which is currently open only to not-for-profit homes (Moritz, Ft. Worth Star-Telegram, 5/10). The measure passed on an 18-11 vote and will move to the House (Hughes, Houston Chronicle, 5/11). The measure is one of several House and Senate bills that seek to increase public funding for the more than 1,200 nursing facilities in Texas. About 25% of the state's nursing homes have filed for bankruptcy protection, 13 went out of business last year, and more than half are dealing with "some kind of financial difficulty" stemming from low Medicaid reimbursement to nursing homes (Texas ranks 45th in the country) and laws that regulate homes "more aggressively" than in most other states (Kaiser Daily Health Reports, 4/10).