That would likely mean many more low-income Americans who are uninsured, underinsured, or have less access to needed care. States would have to offset the federal funding shortfalls by substantially boosting their own contributions to Medicaid or using the greater flexibility that a block grant would provide to make deep cuts to eligibility, health and long-term care services, and provider reimbursement rates, as CBO notes. As a result, the block grant would sharply shift costs to states, beneficiaries, and health care providers over the next 10 years and the decades thereafter. Federal Medicaid funding would be cut 35 percent by 2022 and 49 percent by 2030, according to the Congressional Budget Office. The block grant would start in 2013 and cap federal Medicaid funding at levels well below what the existing system would provide. In addition to eliminating the Medicaid expansion under last year’s health reform law, leaving millions of low-income individuals who would otherwise gain health coverage uninsured, the plan would further boost the number of uninsured or underinsured Americans by cutting the current Medicaid program by $771 billion over the next 10 years through its block grant proposal (or 22.4 percent compared to current law). The Ryan plan would fundamentally restructure Medicaid by converting it to a block grant.
States where cuts would have topped 40 percent in 2009 include Arizona, Delaware, Hawaii, Idaho, Nevada, New Mexico, and Oklahoma, and states where cuts would have exceeded 30 percent include Alaska, Arkansas, California, Florida, Georgia, Indiana, Iowa, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, North Carolina, Ohio, Texas, Utah, Vermont, Virginia, Wisconsin, and Wyoming.
House Budget Committee Chairman Paul Ryan’s radical proposal to convert Medicaid to a block grant, which the House will consider this week as part of Ryan’s sweeping budget plan, would have cut federal Medicaid funds to most states by more than 25 percent by 2009 and to several of them by more than 40 percent if it had been in effect starting in 2000, according to a new Center on Budget analysis.Įvery state would have received substantially less from the federal government than it actually received under current law, but some states would have received much, much less.
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