Make Them Hear You! is a weekly feature on KGNU, produced by Chris Mohr, letting listeners know how they can have their voices heard on issues up before Congress. You can hear it Wednesday mornings at 8.20am during the Morning Magazine.
While the government shutdown is catching the headlines and is certainly worth your time to weigh in on, it is during crisis moments like this that pet projects of Republicans sometimes slide through almost unnoticed. Trump wants to bypass Congress on Medicaid plan by offering block grants for states and achieve the conservative dream on healthcare for the poor.
The Trump administration wants to overhaul Medicaid in some states. States would get spending limits, along with more flexibility to run the low-income health program that serves nearly 75 million Americans, from poor children, to disabled people, to impoverished seniors in nursing homes. Capping spending means fewer low-income people getting covered, or state-designated cutbacks in health benefits — while proponents of block grants argue that states would be able to spend the money smarter with fewer strings.
In addition to potential legal obstacles presented by moving forward with executive orders without Congress, the Democratic House is sure to oppose such a move.
Administrator Seema Verma has warned increased spending on the Medicaid expansion population could force cutbacks on sicker, lower-income patients who rely on the program.
The administration wants to let states use waivers to reshape their Medicaid programs, but the effort could face legal challenges in the courts. Waivers approved by the Trump administration to allow the first-ever Medicaid work requirements for some enrollees, for example, are already being challenged in two states.
Also complicating the administration’s plans are the new popularity of Medicaid, which has grown to cover about one in five Americans. Voters in three GOP-led states in November approved ballot measures to expand Medicaid.
Some conservative experts said the administration’s plans ultimately may be limited by Medicaid statute, which requires the federal government to match state costs. However, they say the federal government can still try to stem costs by approving program caps.
In recent years, governors have complained about the rising costs of Medicaid, which is eating up a bigger share of their budgets. States jointly finance the program with the federal government, which on average covers 60 percent of the cost – though the federal government typically shoulders more of the burden in poorer states. The federal government covers a much higher share of the cost for Medicaid enrollees covered by the Obamacare expansion.
If you have thoughts on Trump’s efforts to bypass Congress with an executive order for Medicaid block grants for the states, you can contact your congresspeople.