Mark Parkinson says he hasn’t had a good night’s sleep in five years. Parkinson is the CEO of the trade group for nursing homes and assisted living facilities, which means the possibility of funding cuts always looms in the back of his mind.

“Every other week, there is some threat to our funding,” the former Kansas governor said in an interview in his Washington office. “The reason that it is so hard to sleep is that our margins are small. We’re a high-revenue business, but our margins are only 1.9 percent.”