The Trump Administration Is Working on Medicaid Block Grants

The Trump administration is striving to cut Medicaid spending via block grants, a strategy that hinges on coaxing states to accept fewer federal dollars than they currently receive, reports the Washington Post . A small unit within the U.S. Centers for Medicare and Medicaid Services (CMS) is developing a plan to allow states to request consent for federal Medicaid funding delivered in a single lump sum rather than as a percentage of states' total costs. CMS leaders are remaining low-key on this initiative, given political fallout from past Republican efforts to rein in Medicare spending. Healthcare providers, especially those serving low-income beneficiaries, are not enthused by the prospect of block grants, since Medicaid already compensates them at significantly lower rates than Medicare or private insurers, and block-granting the program could prompt states to further slash Medicaid enrollment or reduce payments. American Hospital Association President Rick Pollack says his organization questions whether CMS is legally authorized to allocate Medicaid finding through block grants. "We have long voiced concerns about how block-granting Medicaid could ultimately result in losses of coverage and negatively impact access to quality care," he notes. However, CMS has wide latitude to permit states to experiment with Medicaid programs and the marketplaces by applying for waivers, with CMS Administrator Seema Verma passing work requirements in multiple states and soliciting states to seek ways of bypassing certain Affordable Care Act coverage mandates.