Medicaid Block Grants Partially Replace ACA
Medicaid block grants may be used by the Trump administration to replace the Affordable Care Act. Block grants have been used to provide funds for housing in the past as well as for certain educational programs. The belief has always been the block grants will move money closer to the people who need it, and put it under the control of local governments who better understand the people they serve and their specific program needs.
The administration also believes that Medicaid block grants will significantly reduce fraud, waste and abuse. In a recent analysis published by Avalere it was found that converting to Medicaid block grants could potentially cut Medicaid spending by $150 billion over five (5) years.
Using Medicaid block grants will provide state governments greater control over spending, eligibility and programming. This approach is based on the idea that one size should and does not fit all. Only the local authorities/legislatures have a handle on what is in the best interest of their constituents.
Should Medicaid block grants be approved the legislature will still have to deal with many problems which have both financial and political consequences. How much money should each state receive? How will the grants be adjusted over time? What services will the states be mandated to provide? If a state wants to cover more services or expend eligibility will they be eligible for greater funding?
There have been concerns that if Medicaid block grants are provided on a per capita basis that some states may opt to reduce enrollment, limit benefits or reduce payments to providers and plans. These issues will have to be dealt with by the legislature prior to any program rollout
The legislature will have to deal with the concerns expressed by liberal Democrats that some of the stereotypes regarding Medicaid block grants in inner cities are not used as an excuse to make the program difficult to access, or reduce benefits as an excuse for cost savings.
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