Trump is looking for a new way to cut Medicaid — without Congress

Block grants could be the next front in the Trump administration’s war on Medicaid.

Two years in, senior Trump administration officials are still hunting for new ways to cut Medicaid.

Seema Verma, who runs the Centers for Medicare and Medicaid Services for President Trump, has been exploring whether the agency could implement Medicaid block grants, Politico reported last week. It would represent the most aggressive action yet by the Trump White House to cut Medicaid spending. (The program is unaffected by the ongoing government shutdown, however, because it is considered mandatory spending.)

The details are still to be determined, and the plan might not even be legally permissible: Some experts argue CMS lacks the authority to change Medicaid’s funding formula without congressional approval.

Block-granting Medicaid would be a fundamental change to the program. Under block grants, states would receive a set amount of federal funding, instead of the open-ended funding commitment they currently receive from the feds. The Medicaid spending caps proposed as part of Obamacare repeal were projected to lead to hundreds of billions of dollars in spending cuts and millions of people falling off the Medicaid rolls. Clinton-era welfare reform, which block granted other federal assistance programs, show how dramatic the impact can be.

But this new plan would be merely the latest step in a two-year crusade by the Trump administration to cut Medicaid and fundamentally change the program. CMS has already approved the first Medicaid work requirements under Trump, and thousands of people in the states implementing them have lost coverage. Other smaller restrictions in benefits that had been off the table during President Barack Obama’s tenure are finding a much more receptive audience under Trump. Read more

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Trump is looking for a new way to cut Medicaid — without Congress

Block grants could be the next front in the Trump administration’s war on Medicaid.