A Medicaid block grant would reduce federal spending by $150 billion over five years, and a per capita cap would save $110 billion over the same period of time, a new analysis by Avalere Health finds. One or the other will almost certainly be included in a GOP Obamacare replacement plan.

A block grant would give a fixed amount of money to each state for Medicaid. A per capita cap would limit the amount of funding per beneficiary. These are opposed to the current open-ended system under which the federal government pays a fixed percentage of what a state spends.

Key takeaways:

  • Under a block grant, all states but North Dakota would receive less federal funding for Medicaid.
  • Under a per capita cap, 24 states would receive more funding than they currently do and 26 states plus D.C. would receive less.
  • The impact on states of either model would depend on the state's current federal match rate, Medicaid expansion status and eligibility criteria, scope of benefits, role of managed care and use of provider taxes.

Yes, but: As Caroline Pearson, senior vice president at Avalere, points out, states could respond to either model by cutting enrollment, limiting benefits or reducing payment rates to providers and insurers.

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Updated 1 hour ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

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Hurricane Isaias lashes the Carolinas

People walk through floodwaters on Ocean Blvd. in Myrtle Beach, South Carolina, on Monday. Photo: Sean Rayford/Getty Images

Hurricane Isaias made landfall as a Category 1 storm near Ocean Isle Beach in southern North Carolina at 11:10 p.m. ET Monday, packing maximum sustained winds of 85 mph, per the National Hurricane Center (NHC).

What's happening: Hurricane conditions were spreading onto the coast of eastern South Carolina and southeastern N.C., the NHC said in an 11 p.m. update. Ocean Isle Beach Mayor Debbie Smith told WECT News the eye of the storm triggered "a series of fires at homes" and "a lot of flooding." Fire authorities said they were responding to "multiple structure fires in the area."

Exclusive: Trump declines to praise John Lewis, citing inauguration snub

President Trump dismissed the legacy of the late Rep. John Lewis in an interview with “Axios on HBO,” saying only that Lewis made a “big mistake” by not coming to his inauguration.

The big picture: Trump's comments were a glaring contrast with the praise Republicans and Democrats showered upon Lewis this week, and a default to personal grudges during a week of mourning for a civil rights hero.