Fort Lauderdale, Fla.

Amy Bernard and her brother kept their mother out of a nursing home as long as they could, until Parkinson’s and dementia took their toll and she was seriously injured in a fall.

Bernard is happy with her mother’s nursing home care, but it comes at a steep price: $7,000 per month, an amount that would be beyond the older woman’s means if not for Medicaid, which picks up $3,000 of the tab. Which is why Bernard and many other Americans like her are watching the health care debate on Capitol Hill with trepidation.


The Senate Republicans’ plan to repeal and replace President Barack Obama’s Affordable Care Act would cut projected Medicaid spending over the next decade by 25 percent.

Supporters of the bill say nursing home subsidies would not suffer significant cuts, but opponents say they are inevitable. The uncertainty is frustrating to those who rely on them.

In the case of Bernard’s 83-year-old mother, retired teacher Franceen Golditch, the $4,000 that she receives each month from her pension and Social Security goes almost entirely to the nursing home.

“Without Medicaid supplementing, I don’t know what would happen,” said Bernard, a self-employed graphic artist in Boynton Beach, Florida. She added: “I have a house and kids to support myself. I honestly have no answer.”

While the federal-state Medicaid program is most often associated with poor children and single mothers, almost two-thirds of its spending goes to the elderly and the disabled, even though they make up just 1 in 4 recipients. The reason: Well over half the nation’s 1.3 million senior citizens in nursing homes receive Medicaid. The burden is expected to balloon as the 74 million surviving baby boomers — those born between 1946 and 1964 — get older. They are 52 to 71 now.

In part because of the Medicaid cuts, the GOP bill lacks the votes to pass in the Senate, which is expected to take up the measure again.

The bill would cut Medicaid’s projected budget over the next 10 years by a combined $772 billion, according to the Congressional Budget Office. That would lower the amount projected to be spent federally on Medicaid during that time to about $4.2 trillion.