Forthcoming guidance by the Trump administration that would allow states to receive a portion of their Medicaid funding as a block grant has providers fearful of the “very real possibility of cutbacks in [the long-term services and supports] sector.”
The Centers for Medicare & Medicaid Services is expected to announce details for a Medicaid block grant program today, according to multiple national media outlets. The program will reportedly be called “Healthy Adult Opportunity” and allow states to cap a portion of their spending on Medicaid, Politico reported Wednesday. States also would be allowed to limit health benefits and drugs available to some patients.
LeadingAge President and CEO Katie Smith Sloan said a federal block grant program would be a “stark shift from the program’s currently open-ended financing” that would “effectively limit how much funding is available for the Medicaid program.”
The anticipated guidance is expected to allow states to apply for block grants via waivers for the expansion population — adults between the ages of 19 and 64, Smith Sloan explained.
“While the guidance is not expected to include older adults or long-term services and supports, aging services providers should still be concerned because block grants to the expansion population could lead states to pare other aspects of the Medicaid program. Because so much of Medicaid goes to long-term services and supports, we are concerned about potential cutbacks in our sector,” she said.
Smith Sloan added that LeadingAge has opposed block grants and similar initiatives over the years because they’re designed to reduce federal Medicaid spending.
“Sooner or later, block grants combined with state balanced budget requirements and other state regulatory responsibilities will force states to take steps to pare back their Medicaid spending by either kicking people out of the program, cutting back on covered services, cutting payments to health care providers — or some combination of those strategies,” Smith Sloan said.
“Because so much of Medicaid goes to long-term services and supports, LeadingAge is concerned about the very real possibility of cutbacks in our sector. States just would not be able to save enough money to meet the limits of a block grant by reducing spending on other aspects of their Medicaid programs, including the expansion population,” she said.
Smith Sloan added that the organization’s position still holds true. “Medicaid, while a crucial lifeline for poor people, is a consequential resource for others, including middle-class families, as well. It is how they pay for long-term services and supports.”
The American Health Care Association said it will be reviewing the plan once it’s released but noted that any funding decreases would hurt providers and residents.
“Most people who reside in nursing centers rely on Medicaid, as well as tens of thousands of seniors in America’s assisted living communities,” said Mike Cheek, AHCA’s senior vice president for reimbursement policy. “Any reduction in already limited Medicaid resources will be detrimental to providing the quality care on which our nation’s most vulnerable residents rely.”
