CMS unveils plan to allow states to cap Medicaid spending, shift to block grants

The Trump administration said last week that it would allow states to cap Medicaid spending for many adults with lower incomes, a major shift long sought by conservatives that gives states the option of reducing health benefits for millions who gained coverage through the program under the Affordable Care Act (Source: “Trump Administration Unveils a Major Shift in Medicaid,” New York Times, Jan. 30, 2020).

Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, said states that sought the arrangement — an approach often referred to as block grants — would have broad flexibility to design coverage for the affected group under Medicaid, the state-federal health insurance program for the poor that was created more than 50 years ago as part of President Lyndon B. Johnson’s Great Society.

The CMS announcement comes as the agency’s efforts to let states require adults on Medicaid to work or train for a job — which led to 17,000 people in Arkansas losing coverage in 2018 — are mired in court battles.

“Government has a solemn responsibility to provide for the most vulnerable among us,” Ms. Verma said in a morning call with reporters. “Part and parcel of that responsibility is making sure the Medicaid program is sustainable.”