Skip to main content
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Payment
January 16, 2019 12:00 AM

Medicaid block grant waiver reports revive hospitals' funding worries

Robert King
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    Hospitals are furious that the Trump administration is reportedly exploring allowing states to convert their Medicaid programs into block grants, a policy the industry fervently fought when Congress tried to repeal the Affordable Care Act.

    If states take advantage of the block-grant flexibility, first reported in Politico, it would cap federal spending for Medicaid in those states and could leave them on the hook for any expenditures over that limit. States would either have to cut their Medicaid rolls or payments to disproportionate-share hospitals and nursing homes to curb spending, some experts said.

    Chip Kahn, CEO of the Federation of American Hospitals, told Modern Healthcare that he is concerned about how block grants will affect access to coverage and questioned whether the CMS can legally allow these waivers.

    Other hospital industry groups also were worried about the impact of the grants.

    "We have long voiced concerns about how block granting Medicaid could ultimately result in losses of coverage and negatively impact access to quality care," said Ashley Thompson, senior vice president of public policy analysis at the American Hospital Association.

    Both groups said that states have flexibility under federal waivers to make changes to Medicaid and questioned the need to install a block-grant program. Kahn also questioned why a state would willingly sign up for a block-grant waiver if it meant possibly lower federal Medicaid funding if the state goes over the cap.

    Patricia Boozang, senior managing director at the consulting firm Manatt Health, said it is too soon to determine how popular block grants would be, adding that the "devil is in the details."

    "Are we talking about a guidance that would have stringent caps on Medicaid spending or are we talking about something that would foster spending targets, which is what states do for waivers now in setting budget neutrality caps," she said.

    So far the CMS hasn't put out guidance on what flexibility states could receive from block grants.

    The agency did not confirm it was looking at a block-grant waiver program, but a spokesperson said that the CMS is open to giving states the option to adopt a block grant.

    "As the administrator (Seema Verma) has stated publicly, we believe strongly in the important role that states play in fostering innovation in program design and financing," the spokesperson said. "We also believe that only when states are held accountable to a defined budget can the federal government finally end our practice of micromanaging every administrative process."

    The exact guidance will be critical to determine whether a state actually signs up.

    "I haven't met the state yet that would volunteer for a cut in its federal Medicaid funding," tweeted Drew Altman, CEO of the Kaiser Family Foundation. "A few might negotiate a cap on some or all of its program in return for some more flexibility—maybe. Not clear what these new 'block grant waivers' will amount to."

    Block grants are not a new fight for hospital groups. In fall 2017, a bill to repeal the Affordable Care Act sponsored by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) would have converted Medicaid into a block-grant program.

    The lawmakers said that the block grants are key to reining in an out-of-control entitlement program and that it gives more power to states to develop a Medicaid program that meets their needs.

    "Instead of a Washington-knows-best approach like Obamacare, our legislation empowers those closest to the healthcare needs of their communities to provide solutions," Graham said in a statement in September 2017 when the bill was introduced. "Our bill takes money and power out of Washington and gives it back to patients and states."

    Hospital groups vehemently opposed the bill. The AHA wrote to congressional leaders in September 2017 that Medicaid funding cuts could have "serious negative consequences for communities across America" unless the lawmakers made sure alternative coverage is available.

    A September 2017 analysis from the consulting firm Avalere Health estimated that Graham-Cassidy's block-grant program would have cut federal Medicaid funding by $205 billion through 2026 and more than $4 trillion over the next two decades.

    GOP Senate leadership eventually scuttled the bill because of insufficient support from Republican senators.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    wegovy
    Insurers, PBMs restrict access to weight loss drugs as demand soars
    CarbonHealth_Reception_1.jpg
    California contract dispute mirrors national trends
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Daily Finance Newsletter: Sign up to receive daily news and data that has a direct impact on the business and financing of healthcare.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing