The Trump administration is reportedly finalizing a proposal to begin dismantling Medicaid, bypassing Congress in the process. The administration is considering fulfilling the long-held Republican dream of turning the program into a block grant through a waiver process, which would allow states to forego the normal funding stream for what the administration calls “flexibility.”
The nation’s hospitals call it bullshit. If states decide to use the block grants, federal funding for the program will be capped, and states would then be responsible for filling healthcare needs beyond that cap, either by kicking people out of the program or reducing payments to the hospitals that care for the uninsured and to nursing homes.
Chip Kahn, CEO of the Federation of American Hospitals, told Modern Healthcare that he is worried about what this would mean for hospitals and access to coverage, and he also “questioned whether the [Centers for Medicare and Medicaid Services] can legally allow these waivers.”
His organization isn’t the only one “furious” at the proposal. “We have long voiced concerns about how block granting Medicaid could ultimately result in losses of coverage and negatively impact access to quality care,” said Ashley Thompson, senior vice president of public policy analysis at the American Hospital Association. That’s one of the reasons the AHA, along with the other hospital groups, strenuously opposed a block-grant proposal from South Carolina Republican Sen. Lindsey Graham and Louisiana Republican Sen. Bill Cassidy offered up as Obamacare repeal. The AHA officially opposed the proposal, telling congressional leaders that it would have “serious negative consequences for communities across America” unless alternative coverage for low-income Americans was guaranteed.
The bill ended up going nowhere because there weren’t enough Republican senators supporting it. Which is why the Trump administration is trying to get it done this way. Probably illegally. As usual.