The Trump administration is taking its biggest step yet to roll back Medicaid. The Centers for Medicare and Medicaid Services announced a plan that would cap spending on the government health care program for the poor and give states the ability to scale back Medicaid spending by converting part of their Medicaid funding into a block grant.
The program — labeled “Healthy Adult Opportunity” — will allow states to ask permission to end their traditional, open-ended Medicaid program and put hard caps on how much money states and the federal government will spend on the poor and disabled.
The block grant will apply to the Medicaid expansion that was part of the Affordable Care Act.
Anyone who is covered by traditional state Medicaid programs, disabled or eligible for long-term care is excluded. Other low-income adults, children, pregnant women, elderly adults, and people with disabilities will also be excluded.
Under the current system, the federal government matches a certain percentage of state spending on Medicaid, and the funding changes depending on how many people need coverage.
The new block grant program will allow states to more flexibility in how they run their program. States will get a fixed amount of money, regardless of outside circumstances.
States will have the ability to spend it however they see fit, without some federal guidelines.
For example, the program will allow states to impose work requirements, cut provider payments, and require cost sharing and premiums without additional permission from the federal government.
CMS Administrator Seema Verma told The Hill that states will have the option of implementing the block grant program. She also said states would not be allowed to limit health benefits.
Lawmakers in Tennessee have already submitted a waiver request to the Trump administration to impose block grants, and Alaska and Oklahoma have also expressed interest.
Verma said the agency is reviewing Tennessee’s request, but since the state did not expand Medicaid, it would not be eligible for the program.