“Block Grant” Medicaid Waivers Would Pose Serious Risks

June 27, 2019


‘Block grant’ waivers allow states to walk away from previous commitments to provide certain beneficiary protections in exchange for caps on the funding they receive.   New York has a fairly comprehensive set of mandated and optional populations it chooses to cover under the Medicaid Program, but if caps are enacted, states across the country may be forced to make draconian decisions about how it spends Medicaid funds.  Block grant proposals have come and gone over the years (decades).  Advocates have beaten back these federal proposals but its’ also true that New York has seen its’ own share of deeply troubling proposals that would make certain mandatory Medicaid eligible populations optional.

The NYS Council has always taken a strong position in opposition to block grant proposals that we believe would pit deserving Medicaid populations against one another here in New York with the loudest and/or most politically connected voices carrying the day. Block grants as currently imagined by the Trump Administration must be beaten back.


The Center on Budget and Policy Priorities issued a research brief about block grants which included a new report on block grants.  See below:

Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma has said she wants to use Medicaid waivers to let states ignore various federal standards and beneficiary protections – and avoid federal oversight – in exchange for agreeing to caps on the federal Medicaid funding they receive.

As explained in our new report, such “block grant” waivers would pose serious risks to beneficiaries, health providers, and states.provide 

Medicaid’s coverage guarantee means that coverage is there when it’s needed: people who lost their jobs or get sick can enroll when they qualify and receive a core set of health care services that all states must cover.

These waivers would end that guarantee – or eliminate the federal oversight that ensures that states, health plans, and providers comply with it – which would worsen access to care, health, and financial security for Medicaid enrollees that would very likely increase uncompensated care costs for hospitals and other providers.

  Download the PDF (11pp)

Additional Resources

 ›  We also have a two-page brief on the “block grant” waivers
 ›  We’ve updated our 2018 paper on how partial Medicaid expansions fall short