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Tennessee Gov. Bill Lee. Photo: Terry Wyatt/Getty Images

Tennessee is formally asking the Trump administration today to transform its Medicaid program into a block grant — the first real test of an idea that has captivated conservatives for years.

Why it matters: Tennessee's request will test the bounds of what the Trump administration can do on its own, as it seeks to overhaul the Medicaid program. And if it’s successful, it would usher in a new model for a program that covers some 75 million people.

How it works: Medicaid today is administered as a joint state-federal program, whose costs go up and down as enrollment and health care costs go up and down.

  • Tennessee wants the federal government to convert the state’s Medicaid funding into a simple block grant, giving the state far more flexibility over how to spend that money.

What they’re saying: Critics fear a block grant would ultimately lead to states kicking people off their rolls or pulling back services.

  • “We’re committing ourselves to not doing that,” Gabe Roberts, Tennessee’s Medicaid director, told reporters Wednesday.
  • He said the plan has been modified since it was first proposed to clarify that the state would use its new flexibilities — and, ideally, savings — to cover more people or additional services.

Details: Tennessee’s proposed block grant would be based on its existing Medicaid spending and would increase each year based on federal projections of health care costs.

  • State officials believe their program would be cheaper than the status quo, and they proposed splitting those savings 50/50 with the federal government.

What’s next: Gov. Bill Lee told reporters Wednesday that this will be a negotiation with federal officials, with whom the state had discussed its plans as recently as last week.

The bottom line: This would be a radical transformation of a major health care program, and it’s not at all clear that the Trump administration alone — rather than Congress — has the legal authority to revamp the Medicaid program so thoroughly.

Go deeper

Updated 3 hours ago - Sports

The potential GOAT of chess faces intriguing challenger

Illustration: Sarah Grillo/Axios

The World Chess Championship between Norway's Magnus Carlsen and Russia's Ian Nepomniachtchi began on Friday, 1,094 days after Carlsen won his fourth consecutive title.

Why it matters: During the long, COVID-fueled layoff, chess entered a new era, and with the championship finally here, the age-old game is ready for its close-up.

Department of Interior proposes raising cost of drilling on public lands

A horizontal drilling rig and a pump jack sit on federal land in Lea County, New Mexico. Photo: Callaghan O'Hare/Bloomberg via Getty Images

Oil and gas companies should pay more to drill on federal lands and waters, the Department of the Interior argued in a report released Friday, saying that the current rates were "outdated."

Driving the news: The Department of Interior report said that the federal government's oil and gas leasing and permitting program "fails to provide a fair return to taxpayers, even before factoring in the resulting climate-related costs that must be borne by taxpayers."

4 hours ago - Health

U.S. to restrict air travel from 8 countries over new COVID variant concerns

A COVID-19 vaccine is administered. Photo by Joe Raedle/Getty Images

The U.S. will impose new air travel restrictions in response to the Omicron variant, a new COVID strain first detected in South Africa, President Biden announced Friday.

The big picture: Air travel from South Africa, Botswana, Zimbabwe, Namibia, Lesotho, Eswatini, Mozambique and Malawi will be restricted starting on Monday.