The House Manager ’s Medicaid Amendments: The State Block Grant Option

The 1995 Medicaid block grant provisions contained in the Balanced Budget Act of 1995 that was sent to (and vetoed by) President Clinton consumed 100 pages of dense legislative drafting. The block grant provisions of the American Health Care Act (AHCA)—which faces an imminent vote on the House floor—are much more efficient, taking up about eight pages in the House Manager’s Amendment (Policy Changes). Read in some detail—although there is not much detail to read—the block grant option can be read as an astonishing expression of legislative policy, and even more so perhaps, a statement of child health policy. The lax nature of the amendment can be seen in the lack of federal integrity controls over hundreds of billions of dollars in federal spending. And the public health implications of the amendment can be seen in the degree to which the provision would—as a statement of general federal policy—move the role of government away from ensuring access to adequate health care for its very poorest residents, who, under the amendment’s terms, disproportionately are infants and children. Titled “Flexible Block Grant Option for States,” the amendment adds a coda of sorts to the bill’s new Medicaid per capita cap payment system. Under the amendment, states would have an option to receive a certain portion of their federal Medicaid funding in the form of a block grant. A state would opt for the block grant model on a 10-year basis and would ...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Medicaid and CHIP ACA repeal and replace AHCA block grants Medicaid block grants Medicaid per capita cap Source Type: blogs