The Centers for Medicare & Medicaid Services announced policy changes this week that could shake up how states receive their Medicare funding.
The new policy would give states the option to receive part of their Medicaid funding through a block grant, an amount determined by a cash cap based on the number of enrollees or through negotiations with CMS. The move is expected to cut federal Medicaid spending.
The federal administration says this will give states more autonomy to manage Medicaid money on their own terms. Reports say the changes are aimed at attracting Republican-led states who have not expanded Medicaid, and want to limit spending and the size of the program.
Together, Louisiana and Arkansas create an island of states in the South that have expanded Medicaid under the Affordable Care Act; Gov. John Bel Edwards did so in 2016 as his first act as governor. As a result, the state’s number of enrollees topped more than 500,000 last year.
Louisiana Department of Health officials declined to comment on the announcement and how it might affect the state.
Critics say the new rule will limit coverage, decrease enrollment numbers and have the biggest impact on those who receive coverage under states’ Medicaid expansions.
Replacing Medicaid funding with block grants has been tried, and failed, before. Sen. Bill Cassidy was co-author of a bill in 2017 that would have repealed and replaced the ACA.
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