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    Medicaid expansion must remain safe in healthcare reform


    If, however, Medicaid is not available and doesn’t cover his nursing home admission as was proposed with the new and improved Affordable Health Act, Mr. K. won’t be able to stay in the necessary environment. He will follow a pattern known to most physicians of repeated admissions with a bounce back to his home (which, by the way, is not worth much money because of the patient’s inability to provide upkeep over the last many years, so can’t be used as a down payment for nursing home care) where he will ultimately fall again and end up in the hospital.


    More from Dr. Rousche: How to stay engaged with patients—in spite of your EHR


    At some point, life in his home will just become too dangerous and difficult. If there is no Medicaid available for the patient, he has nowhere to go. Neither son is capable for various reasons of taking him into their homes. There is not enough money for 24/7 aides or visiting nurses, even if Mr. K. would allow it.

    This dear man will need Medicaid! For now, it seems as though it will be available at least for the limited future. The current battle over Obamacare’s overhaul is on the back burner. Let’s hope if it comes back into the political realm for reevaluation that the replacement or changes include a humane proposal that includes ongoing Medicaid for our most vulnerable patients. I don’t think there is a doctor anywhere, republican, democrat, or independent, that would disagree with that.


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