[NYAPRS Enews] WH to Present Medicaid Block Grant for Medicaid Obamacare Expansion Enrollees this Thursday

[Harvey Rosenthal]

NYAPRS Note: The Trump Administration will be rolling out its plan this Thursday to cap federal Medicaid via a block grant approach that has long been opposed by healthcare, beneficiary and disability advocates and that is targeted solely to those Americans who enrolled via state Medicaid expansion programs. See critiques below. The plan is expected to be tied up for years in litigation and may could assuage some proponents while arming Trump's critics with more ammunition that he's attempting to cut health services in an election year.

White House Signs Off On Medicaid Block Grant Plan
By Dan Diamond  Politico  January 25, 2020
The Trump administration on Thursday will announce a long-developing plan to overhaul Medicaid by letting states shift some program funding to block grants, four individuals with knowledge of the announcement confirmed.
"The status quo is unacceptable," said a senior administration official. "We have to give states some more flexibility."
The plan - developed for more than a year by CMS Administrator Seema Verma - is slated to be announced at a Jan. 30 event that HHS has called "Transforming Medicaid: A New Opportunity for Better Health." POLITICO obtained a copy of the invitation sent to outside groups.
The plan would specifically target Medicaid recipients who joined the program under Obamacare's coverage expansion, by encouraging states to apply for Section 1115 waivers that would allow them to cap their spending on those patients. The pending policy and internal fights<https://protect-us.mimecast.com/s/2dtZCxkyvxhV4Gh8GOYG> surrounding such a fundamental change to the safety net program during an election year include concerns that it would allow critics of President Donald Trump to charge that he was cutting health care services...
Democrats have said that any attempt to cap Medicaid spending could lead to recipients losing access to health care while circumventing Congress' intent for the program. Advocates for the poor and other critics have said that any block grant plan would be illegal and have promised to sue to block the change. Two administration officials acknowledged that they expect the policy to be tied up in litigation.
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Trump Administration Finalizing Medicaid Block Grant Plan Targeting Obamacare
By Dan Diamond  Politico  January 23, 2020
.....Republicans have long argued that states should receive defined funding for Medicaid, instead of the current open-ended structure in which the federal government matches state spending. Democrats, along with many hospital and physician groups, have fiercely opposed the idea, warning that strict funding constraints would result in cuts to enrollment and health care services.
Democratic lawmakers have promised to fight the administration on block grants, contending CMS doesn't have the authority to restructure the program's financing without congressional approval.
Republicans have proposed Medicaid block grants dating back to the Reagan administration. They argue states could more effectively run the program with a lump sum payment from Washington and fewer federal requirements. Critics of the idea say it would not keep pace with rising health costs and leave states especially vulnerable during economic downturns, when there's greater need for safety net services,
Congress has not been supportive of the idea. Lawmakers during the failed Obamacare replacement effort in 2017, rejected a similar plan to cap spending on Medicaid expansion and private health insurance subsidies, which would have resulted in millions losing coverage.
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The Problematic Law And Policy Of Medicaid Block Grants
Rachel Sachs Nicole Huberfeld  Health Affairs  JULY 24, 2019
The administration's desired policy change attempts to bypass the law, raising serious separation of powers concerns. And capped spending would very likely involve disenrollment and other cost-cutting measures that endanger the lives of the most vulnerable patients. Under a capped spending policy, it is foreseeable that states would face cost-cutting choices that harm the health of Medicaid beneficiaries of all kinds and especially those relying on access to care such as the medications necessary to manage chronic diseases and other life-threatening conditions.,,,

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