Donald Trump
Donald Trump

States may receive their Medicaid funding in block grants under President Donald Trump’s plan to replace the Affordable Care Act, one of his advisers reported this weekend.

White House adviser Kellyanne Conway, appearing on Sunday Today, said that moving the program to a block grant setup — with each state receiving a fixed amount of money — would make sure “those who are closest to the people in need will be administering” the Medicaid.

Conway added that block grants would “really cut out the fraud, waste and abuse,” and beneficiaries would “get the help directly.”

Should the block grant plan be approved, politicians would face “thorny questions with huge political and financial implications,” the New York Times reported. Those questions include the amount of money each state would receive, how initial grants would be adjusted, if states would be required to cover certain services and if states would be able to receive extra money if they choose to expand Medicaid eligibility.

While governors have expressed support for having more control over the Medicaid program, some voiced concerns that the grants may be used to cut healthcare budgets.

“Under such a scenario flexibility would really mean flexibility to cut critical services for our most vulnerable populations, including poor children, people with disabilities and seniors in need of nursing home and home-based care,” said Gov. John Bel Edwards (D-LA) said.

The reported plan for block grants follows an executive order signed by Trump on Friday which allows federal agencies to “waive, defer, grant ­exemptions from or delay” provisions of the ACA that impose regulatory or financial burdens.

Republican lawmakers on Monday released a proposal to replace the ACA with legislation that would give states one of three options: keep the healthcare law in place, switch over to tax-free health Savings Accounts for low-income beneficiaries, or turn down federal funding.