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Trump Takes Aim at Medicaid With Plan That Could Harm Millions

Critic say converting federal funding for Medicaid into block grants will force cuts and reduce access to health care.

U.S. President Donald Trump speaks as Secretary of Health and Human Services Alex Azar and Administrator of Centers for Medicare and Medicaid Services Seema Verma listen during an event on kidney health at the Ronald Reagan Building and International Trade Center on July 10, 2019, in Washington, D.C.

The Trump administration is reportedly planning to intensify its assault on Medicaid by granting certain states permission to convert federal funding for the program into block grants, a move critics slammed as a cruel and likely illegal attack on vulnerable people.

Politico reported Thursday that the plan, which could be finalized as early as next week, would allow the 37 states that expanded Medicaid under the Affordable Care Act to seek waivers to convert funding into fixed sums that could limit states’ flexibility to increase spending in response to public need.

Block-granting Medicaid is a longtime Republican goal dating back at least to the Reagan administration. The Trump administration’s proposal has been in the works for over a year.

Bruce Bartlett, an architect of former President Ronald Reagan’s right-wing economic agenda who left the GOP in 2006, tweeted Thursday that “block grants are just a Republican trick to slash spending without appearing to do so.”

“Money is fungible,” Bartlett said. “Medicaid funding will be used to pay for other programs or even to finance tax cuts.”

News of the plan, led by Centers for Medicare and Medicaid Services Administrator Seema Verma, comes just days after President Donald Trump threatened to slash Medicare and Social Security funding “at some point” should he win reelection in November.

According to Politico, the specifics of the Medicaid proposal—which the Trump administration is looking to implement without congressional approval—are “in flux, as officials work to identify an alternative to the term ‘block grant,’ which has negative connotations in the advocacy community.”

Brad Woodhouse, executive director of advocacy group Protect Our Care, said in a statement that the administration’s latest attack on Medicaid shows “the president’s war on healthcare knows no bounds.”

“In the same week President Trump said cuts to Medicare and Medicaid are on the table,” said Woodhouse, “we now learn that his administration is set to propose benefit-slashing block grants on Medicaid expansion, targeting the benefits of millions of Americans who have gained coverage through one of the Affordable Care Act’s most important, successful, and popular provisions.”

Kim Nelson, a public health advocate and South Carolina Democratic congressional candidate, tweeted Friday that Medicaid block grants “don’t work.”

“They can’t keep pace with the rising costs of healthcare (even the ones that ‘adjust for inflation’) and lead to would-be recipients going without care,” said Nelson. “Forty-three percent of Medicaid enrollees are children. The Trump admin knows that. The cruelty is the point.”

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