Tennessee released a plan last Tuesday to fundamentally restructure its Medicaid program, known as TennCare. If the proposal were to be approved by the Department of Health and Human Services (HHS), the state would become the first in the country to convert Medicaid to a block grant and this would set a dangerous precedent for other states to follow suit.
We have been down the “block grant” road many times before – most recently in 2017 when Congress spent months debating major changes to our health care system, including converting the entire Medicaid program into a block grant or per capita cap – and CDF has long warned of the harms block grants and per capita caps would have on the millions of Americans for whom Medicaid means access to life-saving health care. In the case of Tennessee’s new proposal, the result would be no different – it would fundamentally alter the Medicaid program as we know it, setting a cap on federal Medicaid funding for children, low-income parents, and people with disabilities, leaving 1.2 million Tennesseans worse off.
The timing of this Tennessee proposal is particularly troubling given it comes just a week after the U.S. Census Bureau released new data showing that after decades of hard-won progress expanding health coverage to the vast majority of America’s children, we are now sliding perilously backwards: 425,000 children lost their health insurance in 2018. Coupled with recent reports showing that in 2018 over 800,000 fewer children were enrolled in CHIP and Medicaid than the year before, it is now clear that the efforts of the Trump administration to undermine these proven health insurance programs have resulted in more children unable to access the care they need to survive and thrive. At the same time, their anti-immigrant rhetoric and policies have almost certainly contributed to the loss of coverage and access to care.
If the Administration were to allow this block grant proposal to move forward, it would be yet another harmful attack on health care that will have grave consequences for children and families.