The Trump administration has taken another significant step in overhauling Medicaid, allowing states to ask for a set amount of federal financing for part of their programs in exchange for more local control.
Titled"Healthy Adult Opportunity," the guidance permits states to apply for so-called block grants to cover certain low-income adults, particularly those who gained benefits under the Affordable Care Act's Medicaid expansion provision. Federal funding, which is now open-ended, would be capped, with states receiving either a lump sum or a specific amount per enrollee.
Medicaid covers more than 70 million Americans, or roughly one in five people, particularly low-income children, pregnant women, the elderly and people with disabilities. Some 36 states, plus the District of Columbia, have opted to expand benefits to low-income adults under the Affordable Care Act, adding about 15 million recipients to the program.Total Medicaid spending in fiscal 2018 was $593 billion, with 62.5% paid by the federal government and 37.
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