Washington – Connecticut will reject an offer from the Trump administration to convert a part of its HUSKY program into block grants, a proposal that would likely limit benefits and enrollment.
“This is an ill-conceived and unnecessary change that could fundamentally degrade a critical public health program, “ said Department of Social Services Commissioner Deidre Gifford, whose agency oversees the the state’s Medicaid program, known as HUSKY.
The Centers for Medicare and Medicaid Services announced Thursday it would allow states to apply for waivers that would turn some federal Medicaid funding into block grants.
Right now, Medicaid is an open-ended entitlement program. Those who qualify are covered for medical and prescription benefits while states and the federal government split the cost. In Connecticut, costs are split 50-50.
Under the Trump administration’s proposal, the cost-sharing would continue for most HUSKY patients.
But the state could apply for block grants to cover patients that are enrolled in HUSKY D, an expansion of Medicaid under the Affordable Care Act that allows coverage for low-income adults who don’t have children.
“We strongly reject any efforts to turn back the clock on this important health program.”
DSS Commissioner Deidre Gifford
More than 266,000 Connecticut residents are enrolled in this expanded Medicaid program. To qualify, a childless adult under age 65 must earn less than $17,237 a year.
Currently the state pays about 10% of the cost of covering those individuals and the federal government picks up the rest of the tab, whatever it may be.
“Connecticut has a record of efficiently and effectively operating our Medicaid program,” Gifford said. “Our cost trends are significantly lower than both Medicare and commercial coverage, and our access to care remains excellent.”
She also said that research has demonstrated that the Medicaid expansion program “has positively impacted the physical, mental and economic health of those who receive coverage.”
“We strongly reject any efforts to turn back the clock on this important health program,” she said.
Turning the federal government’s share of the program into block grants is a long-held goal of ideological conservatives who want to scale back the social safety net.
Under block grant funding, states could limit enrollment and benefits because Medicaid would no longer be open-ended, paying whatever is necessary to provide medical care to low-income people who qualify for its benefits.
The new CMS proposal would also give states flexibility in designing plans and exempt them from some Medicaid requirements. States could, for example, limit the drugs that are covered — normally Medicaid covers all prescription drugs.
Health care advocates on Thursday denounced the Trump administration’s proposal.
“If allowed to take effect, today’s guidance would fundamentally alter the Medicaid program for those who’ve gained much-needed coverage through the program’s expansion,” said from Lisa Lacasse, president of the American Cancer Society Cancer Action Network.
She said allowing states to change their funding formula “has the potential to significantly undermine the nation’s health insurance program for low-income Americans, likely leaving millions of people uninsured and unable to access the care they need.”
This isn’t the first time the federal government has used block grants to limit enrollment and cut costs. Former President Bill Clinton and Republicans in Congress in the 1990s turned the cash welfare program into block grants, which severely limited benefits.
It’s unclear how many states will accept the Trump administration’s offer.
But those who do are likely to face court challenges.
While federal waivers promote experimentation, anti-poverty advocates say the Trump administration is exceeding its legal authority because changes in the Medicaid program that cap federal spending require congressional approval.
“Not only do Medicaid block grants directly oppose Congress’ intent for the Medicaid program, but they are illegal…” said a letter to CMS Administrator Seema Verna that was signed by Rep. Rosa DeLauro, D-3rd District, and 35 fellow House Democrats.