U.S. Reps. Cooper, Cohen, other Democrats warn Trump administration against Medicaid block grants

Jan. 29--NASHVILLE -- Calling Medicaid block grants illegal, more than 30 U.S. House Democrats are warning the Trump administration in a letter against providing any guidance on them to states such as Tennessee, let alone approving them.

Democratic U.S. Reps. Joe Kennedy of Massachusetts and Jim Cooper of Nashville spearheaded the letter, signed by a total of 36 members of Congress, including Democrat Steve Cohen of Tennessee. It says block grants are illegal for Medicaid, the state and federally funded health care program for low-income pregnant women, mothers and children and some elderly and disabled Americans.

In their letter to U.S. Health and Human Services Secretary Alex Azar and federal Centers for Medicare and Medicaid Services Director Seema Verma, the federal lawmakers said they wanted to "express our strong concerns about your intent to approve Medicaid block grant waivers. Previous statements from those in the Administration make it clear that the goal of these block grants is to cut benefits and further limit access to publicly funded health care.

"Additionally, the approval of such waivers would directly oppose federal statutes, which describe how the federal agency must make matching funds available to state Medicaid programs," the letter continues.

And it pointedly says "the administration should not issue any guidance encouraging block grant waivers, should reject these waivers and the concept of block grants, and urge any state that is considering this misguided policy to commit its energy to implementing Medicaid as Congress intends."

The letter was first reported by The Hill newspaper.

"States may be enticed by the 'flexibility' of block grant waivers, but in reality it just means less federal funding and less accountability for states to do their constitutional duties," Cooper said in a statement. "They are threatening health care for millions of Americans who need it most."

He said the Trump administration "should stop experimenting on people and start extending health care to everyone."

Tennessee Gov. Bill Lee, a Republican, last year submitted a proposed block grant waiver to convert $7.9 billion of federal funding out of TennCare's total $12.1 billion budget to pursue innovations and, officials say, improve and expand services to existing enrollees.

TennCare, which is the state's version of Medicaid, covers an estimated 1.4 million people. Medicaid is considered an entitlement program with federal dollars matching state expenditures in approved categories, regardless of what a state spends. Critics charge implementing block grants will leave enrollees and states in the lurch during health crises or economic downturns.

But Lee says his "modified" block grant request addresses those concerns by seeking a lump sum that will be adjusted annually for inflation and new enrollees. Still, the proposal was almost universally panned during Tennessee's public comment period with just nine of 1,800 commenters voicing some support and several of those voicing support made it conditional.

Congressional Democrats came forward with the letter as CMS Director Verma, a block grant proponent, prepares to issue guidelines for states seeking to implement such programs.

Last year, a powerful House committee chairman charged Tennessee's proposal was illegal.

Contact Andy Sher at [email protected] or 615-255-0550. Follow on Twitter @AndySher1.

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