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Monday, Jan 23 2017

Full Issue

Trump's Plan To Convert Medicaid Into Block Grants Would Saddle Lawmakers With Tough Decisions

Kellyanne Conway, an aide to the president, says Donald Trump wants to move toward block grant funding so states have the flexibility to cut waste from their programs. But if Congress decides to take that route, it will have to rule on questions such as what to do about inflation or if drug prices go up and how much each state will receive. Meanwhile, not all Republican governors are happy about possible repeal of the health law.

President Trump鈥檚 plan to replace the Affordable Care Act will propose giving each state a fixed amount of federal money in the form of a block grant to provide health care to low-income people on Medicaid, a top adviser to Mr. Trump said in an interview broadcast on Sunday. The adviser, Kellyanne Conway, who is Mr. Trump鈥檚 White House counselor, said that converting Medicaid to a block grant would ensure that 鈥渢hose who are closest to the people in need will be administering鈥 the program. (Pear, 1/22)

"Those who are closest to the people in need will be administering it," Conway said in the interview, which was recorded the Thursday and Sunday. "You really cut out the fraud, waste and abuse, and you get the help directly to them." Medicaid is now funded by the federal government and states together and it has an open-ended funding stream, meaning it pays for all health costs to which its beneficiaries are entitled under the law. (Kodjak, 1/22)

Senior Donald Trump adviser Kellyanne Conway said Sunday part of the new administration's plans for repealing and replacing Obamacare would include converting federal funds for Medicaid into block grants to states. "The replacement plans, I think everybody knows what some of the contours are now," Conway said on NBC's "Sunday Today" show. "Block grant Medicaid to the states, so people who are closest to those in need through Medicaid -- which guarantees health insurance to the poor -- that they will -- that those who are closest to the people in need are really administering it. You really cut out the fraud, waste, and abuse, and you really help directly to them." (Wright, 1/23)

Such a system will mark a drastic change in healthcare coverage for low-income people and a fight in Congress over the formulas that determine how much funding each state receives and what happens to those that have expanded their Medicaid programs under the Affordable Care Act. (Bluestein, 1/23)

As Congressional Republicans begin work on repealing the Affordable Care Act, many of the nation's governors want to make sure that their state budgets don't take a hit during the dismantling process. They're most concerned about Medicaid, the health insurance program for the poor that's run jointly by the states and federal government. ... Among them is Ohio Gov. John Kasich who, along with several other Republican governors, met with GOP members of the Senate Finance Committee last week for a closed-door discussion about the healthcare law. Kasich has been anything but quiet on the subject. (Castele, 1/23)

Medicaid spending聽for all states was about $532 billion in 2015, with about 63 percent funded by the federal government and the rest by states. In expanding Medicaid under the ACA, Republicans in expansion states chose economics over politics, even though it meant cooperating with a law that nearly all conservatives abhor. That calculus won鈥檛 change with the transition in Washington, according to Matt Salo, who heads the National Association of Medicaid Directors. (Vestal, 1/23)

And in other news聽鈥

Poor Americans insured by Medicaid will pay more out-of-pocket toward their healthcare services under proposals favored by Dr. Tom Price, Donald Trump鈥檚 pick to be U.S. Secretary of Health and Human Services. During the first of two committee hearings he faces before the U.S. Senate votes on whether to confirm him, Price said he supports a plan within Indiana鈥檚 Medicaid program that requires a copayment or premium to get a richer benefit package. Price, who goes before the Senate Finance committee this week, favors repealing the Affordable Care Act and its Medicaid expansion and his testimony offers ideas on what he may push to replace the law. (Japsen, 1/22)

Nearly 1 million Ohioans, and 20 million nationwide, are covered under the law's expansion of Medicaid coverage and creation of an insurance exchange marketplace that offers federal subsidies to help many Americans pay premiums. While its potential repeal earned President Donald Trump a number of votes and thrills some people as his administration takes the reins in Washington, it also has left a number of Americans worried about what's next. (Candisky, Johnson and Viviano, 1/22)

鈥淭he single sector in which we project economic growth next year is health care,鈥 said Alaska Department of Labor and Workforce Development commissioner Heidi Drygas in an economic trends report released this month. 鈥淎nd that sector is at risk if Congress repeals Medicaid expansion.鈥 Most Americans enrolled in Medicaid are low-income families, people with disabilities and the elderly, according to CNN. Older Alaskans are a population which have become the main driver of the state鈥檚 healthcare growth, says Alaska Dept. of Labor economist Caroline Schultz. (Starks, 1/20)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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