Reforming America’s health care system is proving to be a complex and arduous task. As the administrator of Clover Health Care in Auburn, I know that the effort by Congress for extensive reform that will increase every American’s access to affordable, high-quality health care is essential. But, I also know that it is equally important that we achieve this objective in a way that ensures that Maine’s most vulnerable citizens are not bearing an undue burden in the process.

Much of the public discourse to date has been focused on access, coverage and the debate over a public option. Yet there has been very little emphasis on the devastating impact that current proposals could have on Medicare-certified Maine nursing facilities and the consumers we serve.

As Congress gets back to work in Washington this month, proposed reform legislation now pending in the U.S. House of Representatives is due for a floor vote. Under the plan, Medicare funding for consumers receiving rehabilitation and skilled nursing services in nursing homes nationwide would be cut by more than $32 billion over 10 years. For Maine’s skilled nursing consumers, this equates to a loss of more than $252 million, according to a recent analysis of the bill by the American Health Care Association. This enormous cut is on top of $12 billion in Medicare cuts just recently imposed by the federal agency that oversees Medicare funding.

Maine’s nursing homes serve an increasingly diverse patient base, and provide a greater variety of cost-effective acute care, rehabilitative and convalescent services that cannot be delivered elsewhere. These services, and the expanded capacity now benefiting our elderly and disabled citizens, are in dire jeopardy due to the sheer size and scope of the proposed Medicare funding cuts because some facilities will not be able to sustain the impact.

Medicare and Medicaid funding are inextricably linked in long-term care. Together, they pay for about 90 percent of all care delivered in nursing homes. Because Maine’s Medicaid program already underfunds the actual cost of providing quality nursing home care by $27 million annually, these Medicare cuts will undermine facilities’ ability to effectively treat this more medically complex patient population. Our federal lawmakers must factor this reality into their thinking and policymaking as the health reform debate ensues.

I understand that all parts of our health care system are being asked to bear some Medicare cuts for the sake of reform that will benefit all Americans. But unlike hospitals that will benefit from increased private insurance or pharmaceutical companies that stand to gain research funding, nursing homes that survive these Medicare cuts will not see any new benefits under the current proposal.

As the public becomes more aware of the impact of health care reform on long-term care, I hope they will become concerned about the viability of their local nursing home. Not only are we caring for loved ones and friends, we are major employers in many communities, providing jobs, tax revenues and economic activity critical to many Maine towns and cities. As caregivers, we do everything we can, every day, to make our residents’ experience a positive one.

We know that Maine’s congressional delegation understands the need to ensure stable, adequate Medicare funding as part of any final health-care reform bill. That is the only way we can ensure our elderly and disabled continue to receive the quality care they are accustomed to, and which they deserve. We ask members of Congress to revise the proposals that contain such deep cuts for nursing home care. Health care reform is critically needed, but not at the expense of the services our elderly count on.

Cynthia Quinlan is the administrator at Clover Manor in Auburn. Nadine Grosso is the vice president and director of communications of the Maine Health Care Association.