Medicaid Block Grants
February 1, 2020
As you continue to read articles on the latest draconian proposals being promulgated by the Trump administration (in this case offering states Medicaid block grants) bear in mind that New York State conducted a significant (voluntary) expansion of our Medicaid Program more than a decade ago and well before the ACA was implemented with all of its’ incentives to states to expand their Medicaid Program. Under then State Medicaid Director Deborah Bachrach, New York seized on an opportunity that became available that did not come with much of a federal match to enroll thousands of uninsured New Yorkers. This was a game changer for thousands of New Yorkers who became insured (often for the first time in their lives).
My initial ‘read’ of the Medicaid Block Grant proposal is that it is unlikely NYS will seize on this opportunity for a variety of reasons including the fact that the Governor went to great pains during his State of the State address to highlight his progressive agenda in the face of conservative efforts to divide and conquer our country. This does not mean that some more conservative Republicans here in New York won’t try to emulate what’s happening in Washington by proposing a narrowing of the front door to Medicaid for certain ‘optional’ populations (who are by no means optional in our opinion). It seems like the MRT 2.0 Workgroup is for the moment the chosen strategy to reign in Medicaid costs chosen but we cannot forget that the Governor’s executive budget proposal does include a proposal that would cut all Medicaid services ‘across the board’ in the event the MRT fails to come up with necessary savings.
It’s a very interesting (and challenging) time in Albany. Stay tuned as we continue to try to make sense of it for you.