Center on Budget and Policy Priorities: Medicaid 'Block Grant' Guidance Will Likely Encourage States to Undermine Coverage
Tomorrow's expected Medicaid guidance from the
Here are four points to keep in mind in evaluating the guidance, along with links to relevant CBPP reports.
* Capping funding while weakening beneficiary protections would put beneficiaries, providers, and states at risk. Medicaid's coverage guarantee means that coverage is there when you need it: people who lose their jobs or get sick can enroll if they meet program eligibility rules and will receive a core set of health care services that all states must cover. Weakening that guarantee -- or eliminating the federal standards and oversight that ensure that states, health plans, and providers comply with it -- would worsen access to care, health, and financial security for beneficiaries and likely increase providers' uncompensated care costs. Meanwhile, capping federal funding would likely shift costs to states, since they would be solely responsible for unexpected costs above the cap instead of sharing those costs with the federal government as they do today.
* The Medicaid expansion has improved access to care, strengthened financial security, and saved lives. In making its case for the guidance, CMS officials will likely argue -- as they have in the past -- that the Medicaid expansion doesn't improve beneficiaries' health. Such claims are indefensible in light of recent research finding that the expansion saves lives. If all states across the country adopted it, it would save as many lives each year as seatbelts do (see graphic).
See chart here (https://www.cbpp.org/blog/medicaid-block-grant-guidance-will-likely-encourage-states-to-undermine-coverage).
A second, even more recent study -- this one a randomized trial, the gold standard for scientific research -- also finds Medicaid coverage for adults saves lives. Other strong evidence shows that the expansion improves financial security and access to care, such as by reducing medical debt and preventing evictions.
Patient advocates, doctors, and hospitals overwhelmingly oppose block grant waivers because they would weaken access to care.
The guidance reflects the Administration's broader Medicaid agenda. After
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