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The CMS Medicaid Guidance Promotes Block Grants and Dangerous Cuts to Coverage

Last month, the U.S. Centers for Medicare and Medicaid Services (CMS) released guidance that fundamentally alters how Medicaid is financed. The proposed “Healthy Adult Opportunity” (HOA) program would offers states the option to use block grants and per capita caps for low-income adult populations — including parents with young children. This is extremely troubling, as we know that when parents lose coverage, their children are more likely to lose coverage as well.

Today, Medicaid is the largest health insurer for our nation’s children, providing affordable, comprehensive health coverage to nearly 37 million low-income children. The changes being proposed by the Trump Administration will fundamentally alter how Medicaid is financed. Converting Medicaid to a block grant will give states a fixed dollar amount of federal funding in exchange for additional “flexibility” to decide what services and treatments they would provide and to whom — and minimal oversight. Current protections for the most vulnerable would likely be eliminated, along with other requirements to provide certain coverage.

Medicaid already offers flexibility to states, allowing each state to meet the needs of its Medicaid population when a natural disaster, public health crisis like the current coronavirus outbreak, or economic recession increases the number of people who need Medicaid. Unlike many private health insurance plans, Medicaid also guarantees specific benefits designed especially for children, known as Early and Periodic Screening, Diagnostic and Treatment (EPSDT), which allows health problems to be diagnosed and treated appropriately and as early as possible. Today’s guidance allows states to opt out of providing EPSDT to some populations, jeopardizing this critical benefit.

While this proposal may not apply directly to children, it does impact low-income parents which in turn, impacts their children. We know that children with uninsured parents have a greater risk of being uninsured even if they remain eligible and are less likely to access preventive care and other necessary services. Child enrollment Medicaid has steadily declined by hundreds of thousands for the first time in several years and last year, more than 400,000 children lost their health insurance. Allowing states the option to fundamentally alter the financing structure of their Medicaid programs — for anyone — will only further decrease access to care and undermine this critically important health insurance program.

From the very early days of this Administration, it has been clear that one of their priorities has been to take away health coverage from vulnerable populations. Without Medicaid’s strong protections, coverage guarantee, and comprehensive, age-appropriate health and mental health coverage, many children would go uninsured or underinsured, increasing short and long term costs for states and local communities while jeopardizing children’s health, academic performance, and future success. Our nation’s leaders must preserve Medicaid as we know it and reject structural changes and cuts that undermine its critical protections, hard-earned coverage and resulting health gains for children made over more than 50 years.

2020-03-03T10:20:51-05:00February 17th, 2020|