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Capitol Correspondence - 01.28.20

CMS Aims to Release Block Grant Guidance by Thursday

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As reported by Politico Pulse:

“The White House signed off on a long-developing plan to overhaul Medicaid by letting states shift some program funding to block grants, POLITICO’s Dan Diamond scooped on Saturday. […] CMS is billing Thursday’s event as ‘Transforming Medicaid: A New Opportunity for Better Health.’” ANCOR will analyze the guidance for potential applications to Medicaid-funded programs for people with disabilities and Medicaid overall once it is released. We keep members informed of next steps as appropriate at that time.

Details of the plan as reported by Politico Pro:

“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 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.

An HHS spokesperson said the department declined to comment on potential announcements. A CMS spokesperson also declined to comment but pointed to Verma’s previous statements on the need to restrain spending on Medicaid, typically the largest line item on state budgets. More than one in five Americans now get health care through the program.”

This older Politico Pro article shows the internal discussions surrounding the guidance – an abbreviated version of that article is available for free on Politico Pulse:

“Even as Verma and her aides work to push through the block grant plan, Trump officials are still battling over its scope and how to best guard it from lawsuits the administration expects from Medicaid advocates. Even the terminology is in flux, as officials work to identify an alternative to the term ‘block grant,’ which has negative connotations in the advocacy community. The plan still needs sign-off from health department lawyers.

Meanwhile, there is internal debate on how broadly to publicize the effort. Verma, who two sources said sees the plan as a legacy-defining achievement, is pushing for an in-person event to announce the policy. Other officials, however, argue a high-profile rollout is unnecessary and could bring more scrutiny to on a controversial proposal.”