Sep 17, 2019

Tennessee becomes first state to introduce Medicaid block grant plan

Illustration: Sarah Grillo/Axios

Tennessee on Tuesday released its plan to transform its Medicaid program into a block grant, marking the most aggressive red-state Medicaid reform proposal yet, reports the Washington Post.

Why it matters, per Axios' Bob Herman: If Tennessee garners federal approval on a policy to cut Medicaid funds — and survives the subsequent lawsuits it'd surely face — it would encourage other conservative states to do the same. This would be a radical change to the medical safety net for the nation's poorest citizens.

The big picture: While converting Medicaid into block grants has long been a goal of conservatives, Republicans were unable to make the change federally in 2017 as part of their Affordable Care Act repeal effort.

  • The state waiver process tees up a test of how far the Trump administration will go to promote state flexibility, and whether current law will allow such a radical change.
    Red state attempts to add work requirements to Medicaid have so far run into road blocks in court.

Block grants allow the federal government to give states a lump sum annually to cover Medicaid costs without having to abide by some of the rules.

  • As it stands, the plan would impact more than 1 million of the 1.4 million residents using TennCare, the state's Medicaid program, per the Washington Post.
  • The plan wouldn't change coverage of prescription drugs and payments to hospitals that treat low-income patients.

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Tennessee block grant plan faces uphill battle

Illustration: Sarah Grillo/Axios

Tennessee's proposal to convert its state Medicaid financing into a block grant could become a landmark restructuring of the program.

The big picture: We don't yet know whether the Trump administration will approve the proposal, whether it'll hold up in court or what outcome it'd have on enrollees — but advocates are warning it‘s probably going to lead to benefit cuts.

Go deeperArrowSep 18, 2019

Medicaid programs embrace Uber and Lyft for patients

More state Medicaid programs are making it easier for patients to use ride-sharing companies like Uber and Lyft as a non-emergency transportation benefit, Kaiser Health News reports.

Why it matters: More than 2 million Medicaid enrollees under 65 years old delayed their care in 2017 because they lacked transportation, per a federal survey.

Go deeperArrowSep 27, 2019

Medicaid programs willing to boot out drug pricing middlemen

Pharmacy benefits are changing in many state Medicaid programs. Photo: Scott Olson/Getty Images

Michigan's Medicaid program is proposing to fire the pharmacy benefit managers that handle its prescription drug claims and negotiate prices. The state would manage drug coverage itself, starting Dec. 1.

The big picture: More state Medicaid agencies have determined that outsourcing all negotiations and operations of prescription drugs to PBMs has not produced the dramatic savings they were promised.

Go deeperArrowOct 8, 2019