Gov. Jan Brewer, R-AZ

A top Centers for Medicare & Medicaid Services official said this week that turning Medicaid into a block grant program is not a viable solution for easing state budget woes.

Block grants take away states’ power to draw down federal money when costs go up, said Cindy Mann, state operations director at the agency, in a speech delivered at the sixth annual Medicaid Congress on Monday. Block grants are a “one-size-fits-all device” that create inequity across states, Mann asserted, according to a report by the Bureau of National Affairs.
Texas is among the latest states to petition President Obama for a federal block grant to operate its state’s Medicaid program, which insures poor children, the disabled and low-income adults. Under the Affordable Care Act, states are not allowed to raise Medicaid eligibility requirements or shrink benefits unless they get a waiver from the federal government first. If the waiver is granted — which many observers in Texas think is a long shot — state officials would be allowed to take actions such as implementing co-pays. The bill’s author, Rep. Lois Kolkhorst (R) has said co-pays would encourage “a culture of personal responsibility and accountability,” according to The Texas Tribune.
Other politicians also have voiced their frustration, with 29 Republican governors sending a letter to the administration this week asking for more flexibility in Medicaid spending. Other governors, such as New Jersey’s Chris Christie (R), are asking for permission to tighten eligibility requirements, according to The Washington Post. Christie’s proposal would deny new coverage to adults in families of three who earn more than $5,300 per year, compared to the current cutoff of $24,645. Arizona Gov. Jan Brewer (R) has also proposed several well-publicized Medicaid cuts.