CMS Issues Guidance for States to Use Block Grants via 1115 Waivers Key Message Platform Background Statement

On Thursday, January 30, 2020, the Centers for Medicaid and Medicare Services (CMS) issued guidance that will allow states to shift program funding to block grants through the use of 1115 waivers. 

The proposed “Healthy Adult Opportunity” is only the latest peg in a years-long coordinated effort to overhaul Medicaid as we know it. CMS Administrator Seema Verna made the announcement during an event titled, “Transforming Medicaid: A New Opportunity for Better Health.” In reality, such a measure threatens, if not dissolves altogether, access to health care — doctor visits, medical counsel, and life-saving medications, treatments, and therapies.   

In general, this move is part of a broader partisan campaign to undermine the Medicaid program and the Affordable Care Act (ACA) that began the moment Repeal and Replace failed in congress in 2017. That campaign includes budget proposals which would cap Medicaid funding for all states and all populations, the new proposed rule on Medicaid fiscal accountability, the public charge rule and the recent partisan Supreme Court decision to lift the preliminary injunction on its implementation, Medicaid work requirements, and efforts at the state and federal level to oppose and undermine Medicaid expansion, and the Texas vs. California ACA repeal case.  

All of these measures, whether the conduits be judiciary, administrative, or Congressional or statehouse level efforts, amount to a continued callous and deliberate exercise spearheaded by the Trump administration and some Republican members of Congress to ignore the health care needs of America’s families — at the expense of the 72 million children, seniors, people with disabilities, and working families who rely on Medicaid to access health care. 

In particular, the implications of this supposedly interpretative guidance, which evades the public comment requirements normally associated with new, major administrative policy and for which there will be no final rule, are far-reaching and will undoubtedly have negative effects for children, seniors, people with disabilities, and access to critical health care services, including adult oral health care. This guidance continues with the Trump administration’s willful tone-deafness to families’ needs and will prove burdensome for governors, states and families. 

This is not improving access to affordable, quality health care for all. This is not an opportunity for better health or health care. This is not who we are.