Medicaid block grants Archives - Safety-Net Association of Pennsylvania

Fitch: Medicaid Block Grants, MFAR Threaten States, Providers

Medicaid block grants and the proposed Medicaid fiscal accountability regulation (MFAR) pose new financial threats to providers and states, according to Fitch Ratings, the financial rating company.

MFAR poses the greater threat, Fitch believes, noting in a new analysis that it could

…reduce total Medicaid spending nationally by $37 billion and $44 billion annually…and by $23 billion to $30 billion for hospitals alone. States, and to some extent providers, would respond to MFAR’s implementation with measures to mitigate the negative fiscal implications.

Bookshelf with law books Block grants, through what has been named the Healthy Adult Opportunity program, also pose a threat, with Fitch explaining that

Capping federal Medicaid contributions, even for a subset of beneficiaries, poses risks to state budgets and those entities reliant on state funding, including local governments and providers. States would need to find revenue or cost savings, either in Medicaid or elsewhere, to offset reduced federal contributions.

Because Pennsylvania safety-net hospitals care for more Medicaid patients than the typical hospital, both proposed policy changes have a potentially greater impact on them.

Last month SNAP conveyed its opposition to the proposed MFAR regulation in a formal comment letter to the Centers for Medicare & Medicaid Services in response to the regulation’s publication late last year. Pennsylvania Governor Tom Wolf has already rejected the idea of using block grants in the state’s Medicaid program.

Learn more about the potential impact of the proposed Medicaid fiscal accountability regulation and Medicaid block grants in the Fitch Ratings analysis “Fitch Rtgs: Medicaid Changes Will Affect States, NFP Healthcare Providers.”

PA Safety Net Admin2020-02-20T06:00:08+00:00February 20th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Verma Responds to Medicaid Block Grant Critics

Last week the Trump administration unveiled its Healthy Adult Opportunity program, a new, optional, already-controversial approach to structuring state Medicaid programs.

Ever since, the program – essentially, Medicaid block grants – has been the subject of criticism from many public officials and health care stakeholders.

Now, Centers for Medicare & Medicaid Services administrator Seema Verma, who oversaw the development of Healthy Adult Opportunity, has responded to the program’s critics in an op-ed piece published in the Washington Post. See her commentary “No, the Trump administration is not cutting Medicaid.”

PA Safety Net Admin2020-02-12T06:00:12+00:00February 12th, 2020|Federal Medicaid issues|Comments Off

Health Care Groups Rebel Against Proposed Federal Regulation, Program

The administration’s proposed Medicaid fiscal accountability regulation and its guidance encouraging states to implement Medicaid block grants have incurred widespread opposition among a variety of health care groups.

The Medicaid fiscal accountability regulation would, if adopted, impose new restrictions on how states raise their share of their Medicaid spending, potentially limiting state participation in Medicaid or necessitating tax increases to fill the funding gap if long-accepted financing tools are no longer available to them.

Bookshelf with law books The Medicaid block grant guidance offers states a blueprint for curtailing their Medicaid costs by imposing limits on that spending that they negotiate with the federal government.

Numerous health care groups have expressed reservations or direct opposition to one or both of the proposals. Among them:

AARP
America’s Essential Hospitals
America’s Health Insurance Plans
American College of Emergency Physicians
American Health Care Association
American Hospital Association
American Medical Association
Association for Community Affiliated Plans
Association of American Medical Colleges
Coalition of Long-Term Acute-Care Hospitals
LeadingAge
National Alliance of Safety-Net Hospitals
National Association of State Budget Officers
National Association of Medicaid Directors
National Continuing Care Residents Association
National Governors Association
Private Essential Access Community Hospitals

Among the groups submitting formal comment letters to the Centers for Medicare & Medicaid Services in response to the proposed Medicaid fiscal accountability regulation was the Safety-Net Association of Pennsylvania. See SNAP’s letter here.

Learn more about why these groups object to these two new policy developments in articles in Axios (“A little-noticed Medicaid proposal could have huge consequences”), Bloomberg Law (“Trump Plan to Tame State Medicaid Finance Schemes Sees Pushback”), Health Affairs (“Proposed Rules On Medicaid Financing Miss Mark And Threaten Access”), Healthcare Dive (“Payers, providers urge CMS to scrap rule targeting supplemental Medicaid payments”), Healthcare Finance News (“Providers, payers, others speak out against federal proposals for Medicaid funding”), McKnight’s Long-Term Care News (“Providers rally against proposed Medicaid supplemental payment rules that threaten ‘major financial burdens’”), McKnight’s Senior Living (“CMS proposal would be ‘major financial burden’ for CCRCs, residents, organizations say”), and U.S. News & World Report (“Governors Warn Trump Rule Could Lead to Big Medicaid Cuts”)

PA Safety Net Admin2020-02-10T06:00:34+00:00February 10th, 2020|Federal Medicaid issues, Safety-Net Association of Pennsylvania|Comments Off

PA Says No to Medicaid Block Grants

Pennsylvania is not interested in pursuing the new Medicaid block grants being offered by the administration, leading state officials said last week.

In a news release, Governor Wolf said that

I expanded Medicaid in Pennsylvania to allow for more than 700,000 people to have reliable health care access. Pennsylvania will not go backwards. I will not risk jeopardizing our progress by going along with another short-sighted, insensitive plan to cut Medicaid…

Department of Human Services Secretary Teresa Miller, who oversees the Pennsylvania Medicaid program that serves approximately 2.8 million people, echoed this sentiment:

Changing any part of Medicaid to a block grant structure is the federal government permitting states to grow health inequities experienced by the poorest Americans. This cruel policy will directly target people who have the most opportunity to see their life and circumstances improved by consistent access to necessary health care and will keep people trapped in the cycle of poverty.

Learn more about why Pennsylvania will not pursue a Medicaid block grant in the Wolf administration news release “Pennsylvania Will Not Participate in Trump Administration Scheme to Cut Medicaid.”

PA Safety Net Admin2020-02-04T06:00:35+00:00February 4th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

Chatter About Medicaid Block Grants Grows

A week after a published report suggested that the Trump administration might be working on a plan to introduce Medicaid block grants, the Washington Post reports that those efforts are under way in earnest.

According to the Post,

A small group of people within the Centers for Medicare and Medicaid Services is working on a plan to allow states to ask permission for their federal Medicaid dollars to be provided in a single lump sum instead of the way they are currently awarded as a percentage of states’ total costs.

While many, including members of Congress, insist that the administration cannot move forward with such a proposal without legislation, others suggest that the administration may offer states the opportunity to participate in Medicaid block grants voluntarily, by seeking a federal waiver. What remains to be seen is whether the prospect of greater flexibility to shape their own Medicaid programs is sufficient to entice states to participate in an approach that almost certainly would result in less federal money for those programs.

Learn more about what the administration is considering and how policy-makers, industry leaders, and others are reacting to the prospect of a push toward Medicaid block grants from the Washington Post story “The Health 202: The Trump administration is working on Medicaid block grants?”

PA Safety Net Admin2019-01-25T06:00:23+00:00January 25th, 2019|Federal Medicaid issues|Comments Off

Temporarily Gone But Not Forgotten

While last week’s withdrawal of the American Health Care Act at least temporarily halted talk of immediate repeal and replacement of the Affordable Care Act, at least one aspect of that proposed legislation, often discussed in the past, is sure to arise in the future as well: replacing the current manner in which the federal government matches state Medicaid funding with Medicaid per capita limits or Medicaid block grants.
In a new issue brief, the Kaiser Family Foundation examines how a switch to per capita limits or block grants might affect low-income seniors served by both Medicare and Medicaid. Among the issues the brief addresses are:

why such a switch would matter to low-income seniors at all
how it might change federal funding of Medicaid for low-income seniors
how states might react in ways that would affect low-income seniors
how it might affect the providers who serve low-income seniors
how such an approach might vary from state to state

Any move to Medicaid per capita limits or block grants could have serious implications for Pennsylvania safety-net hospitals and the communities they serve because these hospitals serve so many dually eligible Medicare/Medicaid patients.
Learn more about a possible change in how the federal government pays for its share of the Medicaid program that will surely find its way into future health policy discussions and debates in the Kaiser Family Foundation issue brief “What Could a Medicaid Per Capita Cap Mean for Low-Income People on Medicare?”

PA Safety Net Admin2017-03-31T06:00:22+00:00March 31st, 2017|Federal Medicaid issues, Medicare, Pennsylvania safety-net hospitals|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its February 2017 newsletter.
Included in this edition are stories about:

the potential implications of turning Medicaid into a block grant program
the governor’s proposed FY 2018 budget
a new federal requirement that hospitals must inform Medicare patients if they are designated as hospitalized under “observation status”
counseling services available through PA LINKs

Find the latest edition of PA Health Law News here.

PA Safety Net Admin2017-03-02T12:21:18+00:00March 2nd, 2017|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2018 budget|Comments Off

Beware Medicaid Block Grants, Analysis Suggests

When the federal government turns housing, health, and social services programs into block grants, funding for such programs erodes over time, according to a new analysis by the Center on Budget and Policy Priorities.
The study found that

Policymakers advancing these proposals often accompany them… with assurances that the new block grant would get the same overall amount of funding as currently goes to the individual programs that it would replace. This new analysis of several decades of budget data strongly suggests, however, that even if a new block grant’s funding in its initial year matched the prior funding for the programs merged into the block grant, the initial level likely wouldn’t be sustained. History shows that when social programs are merged into (or created as) broad block grants, funding typically contracts — often sharply — in subsequent years and decades, with the reductions growing over time.

Of 13 such transitions from appropriation to block grant status in recent years, 11 of the programs shrunk in inflation-adjusted terms, some of them significantly so, with a median decline for the 13 of 26 percent to date.
The analysis also found that

The marked deterioration in block-grant funding over time controverts the common claim by block grant proponents that if funding levels prove inadequate, Congress will step in to provide appropriate additional funding. The general lack of responsiveness of block-grant funding to changes in need contrasts sharply with the high degree of responsiveness of entitlement programs such as SNAP (formerly known as the Food Stamp Program).

The study comes at a time when some policy-makers are talking about converting Medicaid into a block grant program. This proposal has been around for years and periodically resurfaces, as it has in the past year.
For a closer look at what happens when the federal government turns a program into a block grant, go here to see the Center on Budget and Policy Priorities’ report “Funding for Housing, Health, and Social Services Block Grants Has Fallen Markedly Over Time.”

PA Safety Net Admin2016-03-29T06:00:47+00:00March 29th, 2016|Uncategorized|Comments Off

SNAPShots

SNAPShots

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us