WASHINGTON -- With the passage of the American Health Care Act in the House in May, and the release of the Senate's Better Care Reconciliation Act in late June, 番茄社区 examines one of both bills' most significant provisions: a complete redesign of the Medicaid program.
Block granting Medicaid involves giving states a fixed amount of funding to pay for a portion of the estimated healthcare expenses of certain low-income beneficiaries, rather than contributing a set percentage of states' actual spending as is currently done. While it is not a new idea, it is a controversial one.
The idea of reforming the Medicaid program gained traction in the mid-1990s. The Clinton Administration even supported one type of block grant, the per-capita cap. At the time, Republicans favored a traditional block grant, while some Democrats supported a per-capita cap or lump-sum payment given to states historic spending by that state by certain categories of beneficiary, such as the elderly and the disabled, multiplied by the number of beneficiaries in those categories. These lump sum payments would increase by some trend rate, such as the consumer price index.
of this period in our government's history, and it as "irrelevant," noting that spending growth per beneficiary has since dwindled. The issue has resurfaced now that block-granting Medicaid is included as an option in the Republican House and Senate legislation that aims to repeal-and-replace the Affordable Care Act.
The Congressional Budget Office estimates 15 million fewer people will have Medicaid coverage by 2026, compared with current law, if the Senate's healthcare bill is passed.
In these three videos, two policy scholars explore the projected impact of capping federal Medicaid funding for states. Both interviews were filmed prior to the release of the House and Senate bills, and press representatives were present. We spoke with , senior fellow at the Manhattan Institute, a conservative think tank based in New York, who is critical of the current Medicaid funding setup; and , founding chair of the health policy department at George Washington University, who is a vocal supporter of the Medicaid program.
How Does Medicaid Work? (Part 1 of 3): In this first video, Howard and Rosenbaum explain the strengths and weaknesses of the Medicaid program, how it's financed, and whom it's intended to serve.
How Would a Block Grant Impact Medicaid Patients? (Part 2 of 3): In this second video, the scholars highlight the projected impact of shifting Medicaid's financing from the current formula.
How Can Block Grants Help Medicaid and Patients? (Part 3 of 3): Howard and Rosenbaum discuss whether implementing a block grant (or a per-capita cap) could improve the social determinants of health.
Click the arrow on the right of the video player to watch individual videos. Stay tuned to 番茄社区 for more interviews from our "Eye on Repeal/Replace" series.