Skip to comments.Trump Administration to Soon Issue Guidance on Medicaid Block Grants
Posted on 01/19/2020 10:11:35 AM PST by karpov
The Trump administration plans to release guidance as soon as this month for granting states waivers to convert Medicaid funding to block grants, according to two people familiar with the matter, paving the way for a transformation of the 55-year-old program that is likely to reignite a partisan feud.
The impending release comes as a surprise after the Office of Management and Budget, which reviews regulatory actions, indicated in November that block-grant instructions had been withdrawn. Lawmakers and legal advisers speculated that the guidance may have been shelved or significantly delayed.
Approving state waivers to change Medicaid funding to block grants would be among the administrations most controversial moves to reshape Medicaid, a federal-state program that provides health coverage to one in five low-income Americans. Medicaid is the main source of long-term care coverage for Americans and is a guaranteed benefit, or entitlement, for eligible individuals.
Lawmakers in Tennessee, Alaska and Oklahoma have already expressed an interest in pursuing block grants. Supporters of block grants say the change would free states from federal requirements and give them more flexibility to try new ways to increase coverage and cut costs.
Regrettably, the Trump administration is encouraging states to apply for these illegal waivers in its ongoing effort to fundamentally alter and weaken Medicaids financing structure, Rep. Frank Pallone of New Jersey and Sen. Ron Wyden of Oregon, both Democrats, wrote in a Jan. 14 joint letter to the Health and Human Services inspector general.
Medicaid funding is open-ended, meaning the federal government matches state spending. If that funding is converted to a block grant, a state could get a limited, lump sum of federal money instead.
Consumer groups and Democrats say that limitation means thousands of people could lose Medicaid coverage or be unable to enroll if states costs rise
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Their was a State Senator in a midwest state that proposed this in his state but his RINO governator finally got one more swamp vote R to break his stalemate. You see he wanted to combine HSA's and Direct Primary Care for Medicade and projected savings could have been as high as 60%. So what was 20 grand to take care of a family of 4 would have been 8k if my math is correct, that is a savings of $12,000.
Major Insurer with a four letter abreviation told all those in office, you go forward with this you get no money to run. Nevermind the swamp in DC it is every friggen statehouse.
When will these fartknockers learn, leave me alone, don't touch my stuff and stop screwing me.
This is a simple counter to make states like California, which wants to use Medicaid to pay for illegals health care, put up or shut up.
Medicaid is partially funded by categorical grants. Funds are given in the form of a formula grant to each state. Problem is block grants are chunks of money given to states by the federal government with few or no strings attached. The states are given wide discretion on how they can use the money. So in recent years, the ear marking of funds has been twisted for each state to use as they please for their own purposes or re-election fodder.
And it can underfund itself by use and too much need. Perhaps the most well-known block grant (and the one Paul Ryan wants to use as a model for other programs) is TANF. The law converted a cash assistance program known as Aid to Families with Dependent Children (AFDC) into a block grant now known as Temporary Assistance for Needy Families (TANF). Since the funding is set at a fixed dollar amount, it has helped fewer and fewer families over the yearsdown from supporting two-thirds of eligible families in 1996 to just one-quarter of eligible families today. So the question can come out, is there enough money or where is it going?
Other significant block grants include the Social Services Block Grant (SSBG), the Community Services Block Grant (CSBG) and the Community Development Block Grant (CDBG). Ironically, these programs have long been targets for elimination by conservatives, who claim theyre not accountable enough. And they are without earmarking and allowing the liberals to borrow from Peter to pay Paul as has been their practice for over 50 year starting in the early 1960s. So the problem is not near new.
Most, if not all states have some form of Medicaid Estate Reclamation law. They just seldom (if ever) use it. Expanded Medicaid swelled the ranks of Medicaid recipients without regard to worth, only income. The states do NOT want the block grants because they KNOW the money will be spent elsewhere and they don’t want to face voter wrath when they are forced to implement Estate Reclamation.