MEDICAID MATTERS: Return of the Medicaid Block-Granting Debate

The discussion of block-granting Medicaid has returned to the national health policy stage. This weekend, at the annual winter meeting of the nation’s governors, various governors resurrected the issue arguing that states need more flexibility than they currently have to fit their state’s budget and health care needs. 

Because of the populations affected and the potential loss of guaranteed coverage, the consequences of block-granting would be far reaching. Federal funding is currently available to states on an “as-needed” basis but under a block grant, Medicaid funding would be capped. Because there is no guarantee of a federal match, block-granted programs do not need to guarantee coverage for those eligible.

Medicaid has been a lifeline for children and families struggling to gain solid footing after turbulent economic times, as well as senior citizens unable to care for themselves in their own homes and people with disabilities for whom health insurance is simply not available. The bulk of long-term care for many of the nation’s seniors and people with disabilities is provided not through Medicare but through Medicaid. In fact, Medicaid provides coverage and long-term care services to more than 58 million people. It affects virtually every aspect of the nation’s health care system and is an economic engine in communities throughout the country. 

Any substantial changes to the Medicaid financing structure would have a significant impact on the health and economic security of families and communities across the country as those who have come to rely on the program would no longer be guaranteed enrollment.  Medicaid touches the lives and livelihoods of far too many people for it to be addressed with simplistic bumper sticker solutions such as block grants. 

Medicaid block-granting is sure to be one of many topics discussed in the House Energy and Commerce hearing tomorrow titled “The Consequences of Obamacare: Impact on Medicaid and State Health Care Reform.” We’ll follow all proposed changes to Medicaid closely and keep you updated here on Say Ahhh!.

 

Joan Alker
Joan Alker is the Executive Director of the Center for Children and Families and a Research Professor at the Georgetown McCourt School of Public Policy

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