Legislators must act now to save long-term care in Iowa

To the editor:

Our local legislators, Sen. Kraayenbrink and Rep. Meyer, who have been long-time supporters of long-term care, and the rest of Iowa’s legislators must vote to substantially increase Medicaid reimbursement this month or Iowa will see a steeper decline in local access to long-term care.

Already, closures in Fort Dodge and Humboldt have limited local families’ access, and cost-based reimbursement is at the heart of the problem. A majority of Iowa’s long-term care patients rely on Medicaid, but in 2022, Medicaid only covered 80 cents on every dollar of care costs, equating to a 20 percent funding shortfall.

The pandemic surely challenged long-term care, and rising inflation is not making it easier.

Fortunately, this is a year for the legislature to recalibrate the reimbursement rate, adjusting for inflation. Increased reimbursement pays for staff delivering care, and these people deserve increased pay for the work they do.

Still, Medicaid is the ceiling.

Inadequate reimbursement limits Iowans’ access to care. The closures in Fort Dodge and Humboldt were among the 19 nursing homes that closed in Iowa in 2022. In 2023, six more have closed or announced their intent to close.

Losing a community facility puts people out of work. Families search for alternatives that are often miles away. Marian Home takes who we can, but we are already turning away hospital referrals due to limited funding for staffing. Many providers now limit admissions in order to continue serving their community.

Demand for long-term care is expected to continue growing for decades. As legislators vote on the state’s budget this month, we ask them to be thoughtful about the future for older Iowans. Delivering local long-term care is increasingly important to our communities; adequately reimbursing long-term care costs keeps long-term care local and keeps Iowa families together.

Tracy Trotter


Marian Home & Village

Fort Dodge


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