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* The New York Times reports on various gubernatorial reactions to a reported Trump administration plan to block-grant the Medicaid program…
Governors like the idea of having more control over Medicaid, but fear that block grants may be used as a vehicle for federal budget cuts.
“We are very concerned that a shift to block grants or per capita caps for Medicaid would remove flexibility from states as the result of reduced federal funding,” Gov. Charlie Baker of Massachusetts, a Republican, said this month in a letter to congressional leaders. “States would most likely make decisions based mainly on fiscal reasons rather than the health care needs of vulnerable populations.”
Gov. Robert Bentley of Alabama, a Republican, said that if a block grant reduced federal funds for the program, “states should be given the ability to reduce Medicaid benefits or enrollment, to impose premiums” or other cost-sharing requirements on beneficiaries, and to reduce Medicaid spending in other ways.
In Louisiana, Gov. John Bel Edwards, a Democrat, said he was troubled by the prospect of a block grant with deep cuts in federal funds. “Under such a scenario,” he said, “flexibility would really mean flexibility to cut critical services for our most vulnerable populations, including poor children, people with disabilities and seniors in need of nursing home and home-based care.”
Gov. John W. Hickenlooper of Colorado, a Democrat, said that block grant proposals could shift costs to states and “force us to make impossible choices in our Medicaid program.”
If history is any guide, block-granting will lead to less federal money being spent.
* The issue is also mentioned briefly - and rather coldly - in a letter sent by our acting Director of Insurance to Republican congressional leaders. Click the pic for a larger image and the complete letter…
Discuss.
posted by Rich Miller
Monday, Jan 23, 17 @ 1:50 pm
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this seems a rather thin discussion of Illinois and the ACA. yes, cold, and perfunctory. block granting will be bad.
need an actual advocate for those in need in the Gov office.
Comment by Amalia Monday, Jan 23, 17 @ 2:00 pm
3.2 million Illinoisans are in the expanded Medicaid program made possible by the ACA, almost 1 in 4 residents.
Many of them are about to be uninsured. Again.
Comment by 47th Ward Monday, Jan 23, 17 @ 2:01 pm
One of the advantages of Medicaid and Medicare administered at the federal level is that they’re large enough that prices can be negotiated or set. Turning them into block grants (and vouchers) ends this advantage. Then watch health care costs soar.
Comment by Sir Reel Monday, Jan 23, 17 @ 2:01 pm
Block grants are Medicaid cuts. Really bad ones that result in dead people.
If the Illinois governor will not personally take a stand against Medicaid cuts and spend his incredible resources to lobby members of his party to abandon this horror show, he cannot be relied on to do anything.
Comment by crazybleedingheart Monday, Jan 23, 17 @ 2:04 pm
Nice to know Rauner’s Administration cares now…
http://www.chicagotribune.com/news/local/politics/ct-cook-county-medicaid-payments-met-20150723-story.html
Consent decrees are expensive.
Comment by Anon221 Monday, Jan 23, 17 @ 2:05 pm
“As for Illinois’ expanded Medicaid program, the Department of Healthcare and Family Services reports that our total Medicaid population now stands at 3.2 million - almost one-quarter of the state’s population. We have significant concerns about the welfare of these individuals, as well as our ability to run a sustainable program, and urge you to carefully consider the ramifications of proposed changes.”
That doesn’t strike me as particularly cold.
Comment by so... Monday, Jan 23, 17 @ 2:17 pm
These block grants will be funded at about 30% of the actual costs by the time this is policy. This is the republican far right attempting to do away with medical care for the poor.
Comment by oldman Monday, Jan 23, 17 @ 2:21 pm
Democrats in my opinion have done a bad job of highlighting how the ACA has helped very many people. Many people got inexpensive, life-saving private insurance plans.
They’ve also not highlighted the cuts to risk corridors by Republicans, which would have given insurance companies financial breaks while they took in so many sick people. These would have helped offset money losses and could have allowed companies to charge less in premiums.
Rauner was against Medicaid expansion. Now that an election is coming next year, and with the potential for big cuts for low-income and sick people, the tune is changin’. No matter, though. It’s good to stand up for the most vulnerable and sick among us, no matter who does it.
Comment by Grandson of Man Monday, Jan 23, 17 @ 2:31 pm
Given how Illinois finances it’s Medicaid program, i.e. Provider taxes, IGTs, maximizing federal upper payment limit, ect….a block grant would be a disaster for the program, its beneficiaries and providers.
Comment by Dozer Monday, Jan 23, 17 @ 2:33 pm
The big fight will be how to determine how large each state’s block grant will be. Illinois could really get hit hard by this.
Comment by Robert the Bruce Monday, Jan 23, 17 @ 2:36 pm
Over 28,000 home care clients with disabilities take advantage of the Home Services Program that funds the client’s preferred provider. Most if not all of these clients are on Medicaid. A block grant would absolutely decimate this program because the State of Illinois certainly isn’t going to provide financial relief or backup anytime soon.
Time to kill off thousands of jobs and people, the republican way!
Comment by Sick & Tired Monday, Jan 23, 17 @ 2:39 pm
And in a year wrap it right around his neck. The litany of falsehoods flowin’ out of Trump’s mouth can be used to great effect in the campaign ads.
But Rauner has the answer - get those charities to cover the cost.
Comment by Dr X Monday, Jan 23, 17 @ 2:47 pm
Block grants amount to rationing. And Medicaid is a staple of paying for nursing home care.
Comment by In 630 Monday, Jan 23, 17 @ 2:56 pm
To paraphrase former Senator Mark Kirk, “all the dead Americans from that should be laid at the feet of the Republican caucus.”
Comment by Precinct Captain Monday, Jan 23, 17 @ 3:08 pm
In 630 makes a good point: this isn’t just about poor people and health care, else I fear the GOP just doesn’t have them high enough as a priority. But the GOP does have to care about elderly voters, and Medicaid pays for a lot of bills there, too.
Comment by ZC Monday, Jan 23, 17 @ 3:11 pm
Churchill said: “democracy is the worst form of Government except for all those other forms that have been tried.”
One could say a similar thing about the ACA. The GOP is gonna learn that the hard way in the coming months.
Comment by OH Monday, Jan 23, 17 @ 3:15 pm
Wow 6 exhaustive paragraphs from DofI. Certainly another example of the detail heavy understanding of complex government issues that BigBrain and the Super$tars have come to showcase every day.
BTW some Medicare eligible seniors are likely to get S* with the repeal/replace stuff from the GOPies.
Comment by Annonin' Monday, Jan 23, 17 @ 3:21 pm
I’m coming to the belief that America is not a first-world country. We have very high income inequality and no universal healthcare, like virtually every other top economic country.
I was at the massive women’s march this Saturday. If Republicans decimate the poor and sick, I hope there are big actions that go beyond marches–for universal healthcare and issues like wage equality for women.
Comment by Grandson of Man Monday, Jan 23, 17 @ 3:22 pm
These people are so smart. The poor can’t even eat and now they want to drop the hammer on their subpar health care benefits. Sad day.
Comment by Rocky Rosi Monday, Jan 23, 17 @ 3:23 pm
Rocy Rosi is correct. Also, stopping the decrease of the FHA mortgages will hurt those who can afford mortgages least.
one thing that should have been given clear comment in the letter, protect the health insurance of those with pre existing conditions. this cannot be stated often enough and loudly enough. people I know are terrified.
Comment by Amalia Monday, Jan 23, 17 @ 3:37 pm
The letter says nothing. Surprised it goes onto page 2.
Trump ain’t about stability. He’s about change. This doesn’t offer much.
Comment by Letter Monday, Jan 23, 17 @ 3:48 pm
Maybe it would be smart to question WHY healthcare in USA is 2x the cost of healthcare in other developed nations.
TWICE the costs, for much worse outcomes.
Fixing ridiculous medical coding, secretive pricing schemes not available to consumers, monopolies aka networks…. there’s a lot of smart things being promoted as to what could fix all this.
The Aetna/Humana merger got blocked today. Somebody is catching on to what one the real problems is.
Comment by cdog Monday, Jan 23, 17 @ 10:30 pm