Tennessee May Be First State To Achieve Longtime GOP Goal Of Shifting To Medicaid Block Grants

Proponents of the block grant model say it gives states flexibility to more efficiently run their programs and try novel ideas to lower costs. But opponents, including providers and patient advocacy groups, warn that capped models like block grants or per-capita caps would lead to reduced Medicaid funding over time and require states to cut enrollment, benefits and payment rates.

Modern Healthcare: Tennessee Will Test CMS' Willingness To Block-Grant Medicaid

Tennessee Republicans have decided to test the Trump administration's willingness to radically restructure Medicaid by turning it into a state block grant program. The GOP-dominated legislature passed a three-page bill last Thursday ordering the governor to submit a Section 1115 waiver request to the CMS within six months. The waiver would seek the CMS' approval to transform TennCare, the state's $12 billion Medicaid program covering 1.3 million Tennesseans, from an open-ended entitlement program to one where the federal government makes fixed payments. (Meyer, 5/7)

The Wall Street Journal: Tennessee Becomes First State To Embrace Block Grants For Medicaid Funding

Republican Gov. Bill Lee is expected to sign legislation soon seeking Trump administration approval to turn federal funding for the state’s Medicaid program into a lump-sum grant. Currently, Tennessee, like other states, gets open-ended federal dollars because the government matches a percentage of state spending. A switch to block grants would essentially cap funding. The move comes as the Trump administration has encouraged states to explore block grants as part of a White House effort to overhaul Medicaid. The federal-state program covers about 74 million low-income and disabled people, including almost 30 million children, and several Republican-controlled states have already adopted or are requesting federal approval for work requirements and other ways to rein in costs. Growth in Medicaid means the program is making up a larger share of state budgets. (Armour, 5/7)

Politico: Tennessee Will Ask Trump To OK First Medicaid Block Grant

Medicaid for decades has been an open-ended entitlement, without strict limits on how much the federal government pays to states as costs rise. Republicans have long championed Medicaid block grants, arguing that states could better manage their programs if the federal government gave them predetermined funding and significantly greater freedom to set eligibility and benefit rules. Tennessee Republicans spearheading the bill said they didn’t intend to cut coverage for low-income people. They have discussed the concept with the administration and the office of Sen. Lamar Alexander (R-Tenn.), who chairs the Senate health committee. (Pradhan, 5/3)

Nashville Tennessean: Tennessee Governor Poised To Sign Republican Bill To Overhaul Medicaid

Currently, the federal government funnels about $7.6 billion into the state's Medicaid program, commonly known as TennCare. This funding isn't capped — so TennCare can grow as more Tennesseans qualify — but block grant funding would inherently be capped, potentially limiting the size of TennCare in the future. (Kelman, 5/7)

Modern Healthcare: State Medicaid Waivers Getting Approved Faster

The CMS approved state plans to amend Medicaid 16% faster last year than they did in 2016, according to new federal data. CMS Administrator Seema Verma said that the agency will improve the waiver process that allows states to make changes to Medicaid such as eligibility requirements and rates. (King, 5/7)

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