Are Medicaid block grants a good thing?

Background Information

Debate Question:This is what a short summary question would look like.

Medicaid is currently an entitlement program, so everyone who is eligible is guaranteed coverage. The federal government (which pays for about 57 percent of the cost) requires the states (which pay the rest) to cover certain groups of people (for example, low-income children and pregnant women) with specific benefits. States decide how much they spend and the federal government pays its portion on an open-ended basis. Block grants, which are included in the American Health Care Act as an option for states, would change this approach and provide states with fixed annual lump sums. States would have more flexibility to design and run their programs, but also would be responsible for covering any costs beyond the federal grant. Block grants have been a feature of most Republican healthcare Medicaid reform proposals for decades.
in favor
against

Block grants give states more flexibility to provide coverage that best meets the needs of their population. For example, some states will favor specific tests or treatments, or choose to provide less comprehensive policies so they can offer them to more people. 

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

Healthcare needs don’t vary much by state: diabetes, hypertension, cancer, etc. are everywhere. We all are Americans, and our poorer residents should have similar healthcare coverage regardless of which state they live in. And poor people shouldn’t have to settle for bad healthcare coverage.

Zetema PanelistZetema Panelist Against
  • Good Point +3

Block grants allow states to experiment with new models for funding or delivering care. All states will learn from these experiments. 

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

States already have flexibility in their Medicaid programs: determining which services to offer, how to pay providers for their services, how to deliver services (i.e., through managed care), and deciding who is eligible. States can apply for waivers if they want additional flexibility. We’re already seeing experiments without block grants.

Zetema PanelistZetema Panelist Against
  • Good Point +2

Block grants cap federal liability and shift it to the states.

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

Many states will use this as an excuse to cut healthcare to their poorer citizens. 

Zetema PanelistZetema Panelist Against
  • Good Point +1

Block grants don’t necessarily mean less money for Medicaid, but more money could go directly to the states due to savings in federal overhead.

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

Block grants are a smokescreen for cutting Medicaid funding. Even if funding is unchanged the first year, Congress wouldn’t approve the money to keep pace with inflation. Block grants would eliminate a guarantee that everyone who is eligible and applies for benefits would receive them. Some states would restrict eligibility, cut services and make it harder to enroll.

Zetema PanelistZetema Panelist Against
  • Good Point +3

Block grants will allow states to create incentives and penalties that fit each state’s population, such as work requirements, preventive care, and medication compliance.

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

All these are ways to restrict enrollment and save costs at the expense of the poor, which is the real aim of block grant supporters. 

Zetema PanelistZetema Panelist Against
  • Good Point +2

What do you think?

Are Medicaid block grants a good thing?

Are Medicaid block grants a good thing?

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