You may have heard a lot of people talking about “block
granting healthcare” recently Block granting medicaid Block grant it to the states Large block grants We’re working on a block grant issue When Republicans talk about repealing The
Affordable Care Act, they usually mean replacing it with block grants. But before we get to that…
let’s take a step back. What actually are block grants? Basically, they’re a fixed amount of money
that the federal government grants to a state for a specific purpose. There are block grants for education, transportation,
housing, you name it. And they work differently across applications
and industries. Sometimes they provide additional funding
that states wouldn’t otherwise have, like money to combat the opioid crisis. And sometimes, they are policy reforms packaged
as grants. This is where health care comes in. Which the GOP has been trying to block grant
for a long time. The plan we’re proposing will substantially
reduce the need for 465 pages of law. When you get rid of this and say to the governors,
you can in fact solve this problem. The time for action is now. Our approach is to end the onerous one-size-fits-all
approach to medicaid financing. And lately, that strategy has taken the form
of And that means costs and regulations are largely
left to the states to work out. “If you like Obamacare, and you wanna repair
it, you can. If you want to replace it, you can.” Only, it’s not that simple. There are basic issues with block granting
health care that are hard to ignore. Proponents argue that block granting would
give states the flexibility to make the healthcare system work uniquely for them. But, block granting proposals generally reduce
federal spending from the get go. And to make matters worse, grant proposals
thus far give each state a set amount of money. So, when health care costs inevitably continue
to rise, the federal government won’t give more money to the states to make up the difference. So remember when Sen. Graham said
If you like Obamacare, and you wanna repair it, you can. When these grants don’t keep up with health
care needs, states can either: a) Rework the strapped budget to try and keep
Obamacare as is, or b) the more likely scenario: cut health care
program costs, meaning some people will lose coverage. Which brings us to another GOP argument
for block granting healthcare: Cash strapped states will have an incentive
to run a tight ship. Afterall, states will only have access to
however much money they add to the pot. And states have to balance their budgets by
law. You’ll have a race for efficiency rather
than just a race to write bigger and bigger checks. But see, not all states are treated fairly. For example, in a recent attempt known as
the Graham-Cassidy bill, the distribution of funds would disadvantage states that, under
the Affordable Care Act, expanded Medicaid and enrolled more people in the marketplace. My goal is to make sure that if you live
in South Carolina you get the same amount of money as you would if you lived in California. But, because the bill in the short term uses
funding for the Medicaid expansion to pay for block grants,
states like California, New York, and Massachusetts would struggle even more than states who didn’t
expand Medicaid. It assumes that the cost of healthcare across
the country should be the same everywhere. So sure, block granting could seem like a
good idea. I mean, who doesn’t want more flexibility
and incentives to run more efficient programs. But in reality, the money just doesn’t add
up. So after more than three decades of debating
this strategy, isn’t it time we give it a rest?