Medicaid Block Grant and Per Capita Caps Talking Points
** POSSIBLE REGULATORY ACTION **
The Trump Administration announced their plans to issue a proposed rule to “streamline” Medicaid’s regulatory framework to “relieve regulatory burdens” and to “support State flexibility.” Recent reports indicate that the Administration is considering changing Medicaid’s current federal government funding guarantee to states with a more restrictive capped amount, such as a block grant or per capita cap payment, such as what was proposed during the “repeal and replace” Affordable Care Act debate during the last Congress. Easterseals does not support repealing the federal government’s Medicaid match guarantee with a capped funding limit.
• Children and adults with disabilities rely on Medicaid services for their health, well- being, and independence. Medicaid helps: (include your own examples)
o A child with cerebral palsy access physical therapy;
o A student with autism receive behavioral health services;
o A young adult with a spinal cord injury receive personal assistance services to
get to his job; and
o A vulnerable senior access home health services.
• Easterseals partners with state Medicaid programs to deliver Medicaid-funded home and community-based services to children and adults with disabilities and eligible seniors and older adults.
• Easterseals STRONGLY SUPPORTS Medicaid’s current structure where the federal government guarantees it will match a percentage of every Medicaid investment made by a state. The federal Medicaid match percentage ranges from 50 percent (California, New York) to 76.98 percent (Mississippi).
• The federal government’s long-standing Medicaid match guarantee ensures that the federal government and states remain true and committed partners in promoting the health and well-being of Americans.
• Medicaid’s guaranteed federal match ensures that if a state experiences an unplanned health crisis (i.e., natural disaster, epidemic) that requires additional state Medicaid resources, the federal government will uphold its obligation by automatically matching every additional state Medicaid dollar.
• Easterseals is CONCERNED about reports that the Administration is considering repealing the federal government matching guarantee and replacing it with a capped federal funding limit, whether through a block grant or per capita cap allotment.
• Capping Medicaid means states get a SET AMOUNT, either based by the number of state enrollees or a pre-set block grant limit, instead of being reimbursed for the actual cost to care for its residents.
• Under a per capita cap or block grant allotment, states WILL NOT receive extra federal funds to cover an individual’s increasing care—due to deteriorating health or changes in a chronic condition.
• Under a per capita cap or block grant allotment, states WILL NOT receive extra federal funds to cover a promising, but more-costly, drug treatment breakthrough.
• Every dollar a state invests above the capped federal Medicaid allotment is the sole responsibility of the states. The federal-state funding partnership ends once a state reaches the capped federal limit.
• When a state does reach its block grant or per capita cap federal funding limit, the state’s only options for meeting an emerging health epidemic or other health needs would be to either invest more state Medicaid (with no additional federal assistance) or, as the Congressional Budget Office concluded, find savings within its existing Medicaid program, such as through reduced provider payments, restricting eligibility for Medicaid care and services, or eliminating optional Medicaid services, such as home and community-based services that benefit children and adults with disabilities.
• Capping the federal government’s Medicaid obligation is not about improving health, it’s about reducing the federal government spending. Plain and simple
• Capping and cutting Medicaid services through a capped block grant or per capita payment HURTS not HELPS individuals with disabilities who receive their care and supports through Medicaid.
• Easterseals DOES NOT SUPPORT proposals that would CUTS, CAPS or BLOCK GRANTS funding—in any way—for essential Medicaid services and supports.