Biden’s new mandate ignores a crisis that has befallen the long-term care profession | Opinion

Ronald Reagan once said the nine most terrifying words in the English language are “I’m from the government, and I’m here to help.”

Almost 40 years later, the “solutions” proposed by the federal government can still send shivers down our spines. The most recent and frightening example of government sabotage disguised as technocratic problem-solving is President Joe Biden’s sweeping new hiring mandates on nursing homes.

On its face, Biden’s proposal is simple. Many nursing homes are understaffed; facilities with greater numbers of registered nurses and nursing aides can theoretically provide better care; and thus, the president is here to tell you to hire more staff. According to the administration’s estimates, 75 percent of all long-term care facilities will need to add staff, and all of them will be required to have at least one registered nurse onsite 24 hours a day.

Biden’s new mandate, however, ignores the well-documented national crisis that has befallen the long-term care profession for almost a decade: There are not enough skilled nursing staff in this country to hire, and not enough money to pay them. President Biden and his team are proposing to solve a labor shortage emergency in skilled nursing by mandating that facilities hire workers that do not exist with money they don’t have. This is, quite frankly, a boneheaded federal demand, which is why over a dozen governors, including Oklahoma Gov. Kevin Stitt, have signed a joint letter in opposition to the rule. In Congress, Sen. James Lankford has followed suit, introducing a resolution opposing the mandate and Sen. Markwayne Mullin signed on as an original co-sponsor; Rep. Kevin Hern has co-authored a similar measure in the U.S. House.

The Biden mandate is even more frustrating when one considers recent measures taken by the Oklahoma Legislature to inject some sense of financial stability into the skilled nursing care profession. In the 2024 session, lawmakers appropriated $30 million to close a roughly $44 per resident gap between the daily reimbursement rate for Medicaid residents and the projected cost of their care, as projected by the Oklahoma Health Care Authority. The federal mandate — which begins to take effect in August ― obliterates those hard-fought gains, adding $76 million in additional annual costs.

Beyond the eye-popping financial impact to Oklahoma’s nursing homes, the mandate attempts to will into existence workers that nursing home administrators have already tried and failed to recruit and hire. Since 2022, nursing homes in Medford, Sapulpa, Shawnee, Vinita, Ardmore and all across the state have been forced to close their doors because they could not find the skilled labor they needed to meet minimum staffing requirements. The president’s new mandate, completely divorced from that reality, will now lead to more closures if it is not reversed or blocked by lawmakers. Each one of those closures will mean massive disruptions in the lives of vulnerable seniors, as well as in many rural areas, the loss of the largest local employer.

This threat to aging Oklahomans and rural economies is not only alarming, but also entirely preventable. We understand the problem: We do not have enough skilled workers in health care. The only solution is to produce more, and it cannot happen overnight.

To their credit, Oklahoma lawmakers are taking positive steps in this direction. In 2022, the Legislature appropriated $4.5 million to support the launch of Care Careers Oklahoma, which connects long-term care facilities with potential employees and helps cover training costs for workers looking to become Certified Nursing Aides or Certified Medication Aides. That type of investment ― along with incremental increases in the state’s Medicaid reimbursement rate — is the only way to address the workforce shortage. Wishful thinking combined with punitive fines from the federal government will not.

Moving forward, state policymakers must find more creative ways to support workforce training programs that can increase the pool of skilled labor in health care. At the same time, we should all resist and reject harmful mandates from the Biden administration and whoever his successor is. We’ve seen the kind of help the federal government has to offer, and we don’t need it.

Matt Pinnell serves as the 17th lieutenant governor of Oklahoma. He is president of the Senate and set his agenda on workforce development issues.