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