The plan, if enacted, threatens to unleash a “radical change to the medical safety net for the nation’s poorest citizens.”
A social justice advocacy group shot back on Tuesday after Tennessee unveiled a plan to switch the state’s Medicaid program into a block grant program.
“A block grant is a Medicaid cut in disguise, and Tennessee should not be fooled,” said the Tennessee Justice Center.
The administration’s block grant proposal puts the most vulnerable Tennesseans’ healthcare at risk, and it does nothing to solve Tennessee’s urgent healthcare needs, including a rising number of uninsured Tennesseans and continued rural hospital closures. https://t.co/Phei3SkjMY
— TN Justice Center (@TNJusticeCenter) September 17, 2019
The state released details of the proposal (pdf) Tuesday.
Any overhaul of TennCare would need the approval of the Centers for Medicare and Medicaid Services. The Trump administration—to the ire of healthcare and anti-poverty advocates—has been gunning for states to make such a switch.
“If Tennessee garners federal approval on a policy to cut Medicaid funds—and survives the subsequent lawsuits it’d surely face—it would encourage other conservative states to do the same,” reported Axios. “This would be a radical change to the medical safety net for the nation’s poorest citizens.”
As The Associated Press reported, “Currently, the federal government pays a percentage of each state’s Medicaid costs, no matter how much they rise in any given year. For Tennessee, that means receiving approximately $7.5 billion in federal money for its $12.1 billion Medicaid program, or 65 percent.”
CNN laid out how things could change for the state under the proposal:
The proposal from Tennessee—which has not expanded Medicaid—doesn’t follow the typical block-grant idea, which would offer a lump sum payment to a state. It’s seeking to exclude expenses related to outpatient prescription drugs, home- and community-based long-term care, uncompensated care payments to hospitals and several other costs. These would continue to be funded under the current formula.
The block grant funding would rise if enrollment in Tennessee’s program, called TennCare, increases in the future—addressing a major concern that the safety net couldn’t expand in times of economic downturns. Plus, the annual increase in funding would be based on Congressional Budget Office projections for Medicaid growth, which is more generous than inflation.
Another provision: If the state spends less than the block grant amount, it gets to keep 50 percent of the federal share of those savings.
Though it may differ from a typical block grant plan, critics say there’s still plenty of reason for concern.
Joan Alker, executive director of the Georgetown University Health Policy Institute’s Center for Children and Families (DCCF), outlined some of the concerns in a Twitter thread:
Guess who TN is putting at risk? Half the children in the state.
Guess who the state is exempting?: Drug companies.
Tennessee becomes first state with a plan to turn Medicaid into a block grant https://t.co/lUQDk08CUN
— Joan Alker (@JoanAlker1) September 17, 2019
Bottom line re proposed TN Medicaid block grant: Squarely put at risk: kids, pregnant women, parents. Exempted by the state from the new financial risk: Its own admin costs, seniors on Medicare, outpatient prescription drugs; and DSH hospitals.
— Joan Alker (@JoanAlker1) September 17, 2019
Edwin Park, a research professor with CCF, added his concerns:
TN #Medicaid block grant waiver would allow TN to impose restrictive Rx formulary w/ only 1 drug/class. No appeals process or consumer protections & no clear criteria for formulary. Beneficiaries at high risk of losing access to needed Rx just b/c state doesn’t want to cover.
— Edwin Park (@EdwinCPark) September 18, 2019
Following reports in January that the Trump administration was moving to make it easier for states to switch to block grants for Medicaid, Rep. Frank Pallone (D-N.J.), chair of the House Energy and Commerce Committee, which has jurisdiction over Medicaid, said that CMS had no authority to make those change—a point he reiterated on Wednesday.
“This is illegal,” tweeted Pallone, “and the Trump Administration does not have the authority to do this.”
This is illegal and the Trump Administration does not have the authority to do this. https://t.co/9nTtZJllJ6
— Rep. Frank Pallone (@FrankPallone) September 17, 2019
Fox News triggers outrage with graphic comparing how much stocks have risen after racist tragedies
On Friday, Fox News displayed a graph that appeared to compare the amount the stock market has risen in the week after various racial tragedies, including the assassination of Martin Luther King, the beating of Rodney King, the Ferguson incident, and the death of George Floyd.
2. Here’s the video of the graphic as it aired on Fox News this evening. pic.twitter.com/Iww2DnzkkI
— Yashar Ali 🐘 (@yashar) June 5, 2020
Bill Barr denies giving the order to gas protesters for Trump photo-op
America's top law enforcement office on Friday denied giving the highly-controversial order to gas protesters prior to a photo-op with President Donald Trump holding a Bible.
"Attorney General William Barr says law enforcement officers were already moving to push back protesters from a park in front of the White House when he arrived there Monday evening, and he says he did not give a command to disperse the crowd, though he supported the decision," The Associated Press reports.
"Barr’s comments in an interview with The Associated Press on Friday were his most detailed explanation yet of what unfolded outside the White House earlier this week. They come after the White House and others said repeatedly that the attorney general ordered officers to clear the park," the AP reported. "Shortly after officers aggressively pushed back demonstrators, President Donald Trump — accompanied by Barr, Pentagon leaders and other top advisers — walked through Lafayette Park to pose for a photo at a nearby church that had been damaged during the protests."
Steve Schmidt breaks down why Joe Biden should be an ‘easy’ choice for moderate Republicans
On MSNBC Friday, former GOP strategist Steve Schmidt criticized Sen. Lisa Murkowski's (R-AK) claim that she was struggling over whether to support the president — and laid out why she should unequivocally decide she doesn't.
"We saw the president direct violence against peaceful protesters this week, and seen the president lie to the country nearly 20,000 times," said Schmidt. "We've seen the president divide the country and incite violence. And we've seen a level of ineptitude in this historic pandemic that defied description, but included standing in front of the nation when tens of thousands are dead, talking about his ratings or telling the American people that it is a good idea to ingest or household disinfectants. We've seen a president preside over the shattering of an economy. We have seen a president race-bait, demean, disgrace his office, to desecrate the bonds of affection that exist between us as Americans."