Providers Testify to House Committee Against Proposed 80/20 Rule

The House Energy and Commerce Committee heard powerful testimonies Wednesday from senior care providers opposed to the proposed nursing home staffing mandate and so-called Medicaid 80/20 rule, which experts have said would limit older adults’ access to long-term services and supports.

“Americans receiving long-term services and support, including seniors and people with disabilities, need access to quality care,” said Sen. Cathy McMorris Rodgers (R-WA), committee chair, and Sen. Brett Guthrie (R-KY), chair of the subcommittee on health, in a statement. “We’ve heard concerns in our communities that the administration’s recently proposed nursing home ratio rule and so-called access rule will force facilities to close their doors and jeopardize patient care.”

Rodgers made known her support of home- and community-based services (HCBS) in her opening statement. Despite “well-intentioned” proposals to boost the long-term services and supports (LTSS) workforce and their compensation, Rodgers said the rule would “further undermine this workforce.”

“Since 2020, we’ve lost tens of thousands of workers across both HCBS and nursing home settings as workers left the field due to burnout or in pursuit of other opportunities,” Rodgers said during her opening remarks. “These top-down approaches are not the way forward in supporting seniors and people with disabilities.”

LTSS providers, advocates and workers shared their frustrations with the committee. Mary Killough, vice president of operations and government relations at home care provider AccentCare, emphasized that CMS’ proposed 80/20 rule could spell disaster for many providers.

“If CMS finalizes the proposed one-size-fits-all, federally mandated wage threshold, the likely outcome would be that home care providers will close or providers will reduce their service areas,” Killough said. “The administration’s proposal does not address the primary issue that has been suppressing direct care workers wages — and that is the historically underfunded provider payments, the very payments that allow us to provide wages to our direct care workforce.”

Patti Killingsworth, chief strategy officer for LTSS provider CareBridge Health, in her testimony recommended Congress halt CMS’ proposals and take actions to “ensure equitable access to LTSS for Americans in the settings of their choice.”

Ranking member Rep. Mary Eshoo (D-CA), was sympathetic to the witnesses’ testimonies, but acknowledged the need for better caregiver compensation.

“I don’t think anyone that’s working in this industry, that their demands are off the charts,” Eshoo said, calling for the need for a sustained workforce. “Where there are fewer caregivers — even if their pay has gone up — if there aren’t enough then it degrades the level of work.”

Providers testify to House committee against proposed 80/20 rule (