The eight Republican presidential candidates took part in a spirited roundtable-style debate on Wednesday night at Dartmouth College in New Hampshire, tackling a succession of questions on economic-only issues that included health care, Medicare, and Medicaid.

Before the debate began, representatives of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) and its state affiliate met with the candidates, taking advantage of the access afforded by the association’s sponsoring of the debate. The long term care leaders spent their time talking about how nursing homes and assisted living facilities will play an increasingly important role in providing quality care and jobs.

“How we attempt to shore up the deficit and turn around the economy will also affect how we care for America’s seniors and individuals with disabilities, and hopefully the candidates will take this issue to heart as the campaign continues,” said John Poirier, president and chief executive officer of the New Hampshire Health Care Association.

“Our goal is to ensure we can continue to provide access to the quality care our residents and patients deserve. We must educate these candidates and the public about the significance of health care, and particularly long term care.”

Medicare reimbursement reductions that went into effect on Oct. 1, and potentially more in the pipeline, threaten the ability of long term care facilities to do their job in caring for the nation’s frail and elderly, long term care leaders told individual candidates.

During the debate, the top tier hopefuls took most of the spotlight, answering questions from a panel of journalists, and even each other, on how they would right the struggling economy, boost employment, execute fiscal policy, and balance the federal budget.

If polls are correct, the leading candidates are former Massachusetts Gov. Mitt Romney, businessman Herman Cain, and Texas Gov. Rick Perry. The other five candidates are former House Speaker Newt Gingrich, former Utah Gov. John Huntsman, former Pennsylvania Sen. Rick Santorum, Rep. Ron Paul of Texas, and Rep. Michelle Bachman of Minnesota.

There were some health care-related discussions, but most of that time centered on criticisms of President Obama’s health care reform law, the so-called “Obamacare” package that remains very unpopular with Republicans. When grilled about “Romneycare” implemented during his tenure as governor of Massachusetts, Romney denied the two were cut from the same cloth.

“We had a lot of kids without insurance, a lot of adults without insurance. And we said, we don’t want to change anything for the 92 percent of the people that already have insurance,” Romney said, noting the problem with Obama’s plan is that “he takes over health care for everyone.”

Perry did speak on his support for changing the way the federal-state partnership works on funding the Medicaid program by making block grants available to states to pay for care for the poorest of its residents.

Block grants would take the form of federal lump-sum payments to states, a method of payment that Democrats object to on the grounds it could result in loss of health care coverage for millions of people who are poor, sick, and old.