Coconino Voices: Medicaid block grants are just cuts to care

February 28, 2020
Contributed Columns

Since coming to Congress in 2017, I have made improving and expanding access to health care one of my top priorities. Arizonans I talk to are struggling to afford the high costs of prescription drugs and worrying every day that their health coverage will be stripped by partisan lawsuits and proposals targeting those with pre-existing conditions and families that depend on Medicaid.

Currently, more than 71 million Americans rely on Medicaid for their health care. In Arizona, over 1.7 million people are on Medicaid, including roughly 650,000 children.

Last month, the administration proposed a new demonstration program under Medicaid called the Healthy Adult Opportunity (HAO) that would allow states to apply for “block grants”.

Currently, health care providers receive Medicaid reimbursements for the services they provide. However, unlike this open-ended funding arrangement, the HAO proposal would allow states to instead decide upon a fixed payment, either based on total expenses or on a per-enrollee basis.

In practice, these block grants are nothing more than waivers for states to slash funding for their Medicaid programs, target those with pre-existing conditions, reduce protections for beneficiaries, impose higher premiums for enrollees, and restrict eligibility standards.

Further, the HAO proposal would enable states’ Medicaid programs to limit coverage for prescription drugs. Currently, all federally approved drugs are covered under Medicaid. In contrast, the administration’s policy would allow states to choose to cover just one drug per class.

When it comes to cutting costs, federal law already gives Medicaid the flexibility to change from state to state to fit the needs of our diverse population. Arizona’s Medicaid program is completely different from Medi-Cal, California’s program, and reflects the care needs and demographics of our state.

Point blank: the proposed changes made allowable under the HAO block grant system are funding cuts that would undermine key provisions of the Medicaid program and scale back health care protections for our most vulnerable.

A recent study by George Washington University found that these proposed changes to Medicaid would result in community health centers being able to treat five million fewer patients over the next four years. This is unacceptable. In Arizona, community health centers (CHCs) serve hundreds of thousands of Arizonans every year and employ over 6,000 doctors, nurses, and medical staff. Nationwide, CHCs are the primary medical care home for over 28 million Americans.

Any cuts to Medicaid could put CHCs and rural hospitals at risk of closure. Currently, 41% of rural hospitals across our nation operate at a negative profit margin and 120 rural hospitals have closed since 2010.

The administration’s HAO proposal faces bipartisan backlash in both the House and Senate, from governors across our nation concerned for families in their states, and from hospitals, doctors, health care professionals, and patients.

The proposed demonstration program is also in direct opposition to statutes determined in the 1965 Medicaid Act and requires approval from Congress to take effect. I will not allow that to happen.

Earlier this month, I joined my colleagues in voting for a resolution condemning these proposed changes as what they are: attacks on our health care system and those with pre-existing conditions.

I will not sit idly by while partisan attacks on care for our most vulnerable are proposed so casually. I will continue to fight to protect access to quality, affordable health care for our children, elderly, veterans, disabled, pregnant mothers, and those with pre-existing conditions.

My staff are available in Flagstaff, Casa Grande, and Northwest Tucson – and at mobile offices across the First Congressional District – to assist you with your Medicaid, Medicare, and VA health benefits. I encourage you to reach out with questions at any time.

Additionally, I invite you to share your thoughts and concerns about these issues, or any other issues impacting your community, with me and my staff. Contact information is available on my website.