Alex Morisey does his afternoon exercises in his room at a nursing home in Philadelphia, on Wednesday, Feb. 15, 2023. For U.S. nursing home residents receiving Medicaid, all income is garnished and the person is left to rely on a small subsidy known as a personal needs allowance. The federal government hasn't changed the minimum rate, $30 monthly, since 1987. Pennsylvania’s allowance is $45. Wong Maye-E/AP Photo