CMS releases guidance on Medicaid block grants

Published on January 31, 2020

ALEXANDRIA, VA. (January 30, 2020) – The Center for Medicare/Medicaid Services (CMS) released guidance which provides an option for states that accepted Medicaid expansion to convert those funds into a block grant. Currently, the federal government offers matching funds to those states without a limit. Under the new guidance, which CMS refers to as the “Healthy Adult Opportunity”, these funds will be capped at a set amount, limiting the services states can provide. Despite the rebrand from block grants, the outcome is the same – Medicaid funds will be capped, and services will be cut.

This move will weaken benefits and threatens to reverse many of the coverage gains made through the Affordable Care Act (ACA) in at-risk populations, many of whom rely on Medicaid to receive the care they need. Further, states can drop certain drugs from the coverage list, which limits treatment options or prevents certain patients from accessing the medications they’ve already been prescribed. Cancer is a complex condition which often requires treatments with specialists from multiple disciplines. Disrupting access to any of those therapies could severely impact cancer patients.   

The Prevent Cancer Foundation® urges CMS to consider the impact the new guidance will have on patients and their health care. Without consistent resources and funding, states participating in the program will see reduced benefits, smaller reimbursement payments to health care providers and a reduction in quality of care – all while increasing cost-sharing for beneficiaries. 

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