Capitol Correspondence - 04.08.19

Senate Questions HHS Secretary Over Budget Priorities – Timely Given Alaska’s Interest in Medicaid Block Grants

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The U.S. Senate Appropriations Committee held a hearing on the Department of Health and Human Services’ (HHS) proposed budget for FY20, featuring Secretary Alex Azar. This would be the fourth Congressional hearing the Secretary has been called to, in addition to two House committees and one by the Senate Finance Committee. While the President’s proposed budget, including for HHS, does not have the power of law because Congress has the power of the purse, this hearing was relevant to the disability community because of the insights it gave on the Administration’s thinking towards Medicaid.

Specifically, the Secretary’s testimony and one of his answers to Congressional questions reaffirmed the Administration’s commitment to Medicaid reform. In his prepared remarks, the Secretary mentioned the Administration’s continued commitment to state flexibility on Medicaid. As can be seen in the video linked above, the topic also came up at the 1:24:53 mark when Senator Chris Murphy (D-CT) asked about proposed cuts to Medicaid and their potential harmful effects on opioid addiction treatments, which rely on Medicaid and Medicaid expansion funding. The Secretary responded by saying that the Administration’s Medicaid block grant proposal would give states greater flexibility to address important priorities, including the opioid crisis. He elaborated that proposed cuts to Medicaid expansion would allow states to redirect their efforts away from able-bodied adults, and instead focus on vulnerable populations such as the elderly, pregnant women or people with disabilities.

The Administration budget’s Medicaid block grant proposal which the Secretary referred to in that exchange, pulls from the Graham-Cassidy-Heller health care reform proposal which did not pass Congress in 2017. At that time, ANCOR opposed that proposal as written because it would harm people with disabilities by reducing Medicaid funding, and containing no guarantees that any funding within the block grant would go to disability programs. Again, however, the Administration’s budget is only a proposal although it is an important message.

Demonstrating the Administration’s continued interest in Medicaid reform, the Centers for Medicare and Medicaid Services (CMS) has been exploring state Medicaid block grant proposals. According to KToo Public Media, “[Alaska Governor Mike] Dunleavy told President Donald Trump in a letter dated March 1 that top federal Medicaid official Seema Verma has urged Alaska to be the first state to receive Medicaid dollars as a block grant.” ANCOR had noted earlier, less detailed reports of such discussions previously. ANCOR will keep members informed as this discussion evolves and whether there is a need for action.