Jan 21, 2020

Trump administration plans to issue guidance on Medicaid block grants

CMS Administrator Seema Verma. Photo: Steven Ferdman/Getty Images

The Trump administration plans to issue guidance — potentially this month — on state waivers to change Medicaid funding into a block grant, the Wall Street Journal scoops.

The intrigue: This is somewhat surprising, after the Office of Management and Budget indicated in November that the guidance was no longer happening.

Why it matters: Some red states have already expressed interest in block grants, and supporters say they give states more flexibility, but consumer groups argue that they could lead to thousands of low-income people losing health coverage.

Yes, but: Like work requirements and several other pieces of the Trump administration's health agenda, block grants are likely to be challenged in court.

Go deeper: Tennessee block grant plan faces uphill battle

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Trump vs. Medicaid

Illustration: Sarah Grillo/Axios

It may not get the most attention, but Medicaid is the prime target of the Trump administration’s health care agenda.

Why it matters: Medicaid covers about 70 million people — more than Medicare. It’s the biggest item in many states’ budgets. It is a huge part of the health care system, and the Trump administration has been fully committed, since day one, to shrinking it.

Hospitals and Medicaid enrollees lose under Trump's budget

Illustration: Aïda Amer/Axios

President Trump's 2021 budget proposes massive reductions in Medicare and Medicaid spending, which would be felt most acutely by hospitals and Medicaid beneficiaries.

Why it matters: Budget proposals are more about messaging than policies that have any chance of becoming law, but it's still a good indication of the direction the administration would like to head in if Trump wins re-election.

Go deeperArrowFeb 11, 2020 - Health

Appeals court rules against Trump's Medicaid work requirements

Illustration: Sarah Grillo/Axios

The Trump administration violated federal law by allowing red states to impose work requirements on their Medicaid programs, a federal appeals court ruled Friday. The court said the administration had not properly justified its decision, and that it was out of step with Medicaid's statutory goals.

What's next: The most likely next step is an appeal to the Supreme Court. In the meantime, the administration has not won a single favorable ruling in lawsuits over what had once looked like one of its most significant health care policies.