House Democrats launch investigation into Trump administration's Medicaid changes

House Democrats launch investigation into Trump administration's Medicaid changes
© Aaron Schwartz

House Democrats are launching an investigation into the Trump administration’s handling of Medicaid.

House Energy and Commerce Committee Chairman Frank Pallone Jr.Frank Joseph PalloneOvernight Health Care — Presented by That's Medicaid — Deal on surprise medical bills faces obstacles | House GOP unveils rival drug pricing measure ahead of Pelosi vote | Justices to hear case over billions in ObamaCare payments Obstacles remain for deal on surprise medical bills This week: House impeachment inquiry hits crucial stretch MORE (D-N.J.) sent a letter Thursday to the Department of Health and Human Services that asks for information about the administration’s attempts to convince states to make conservative changes to their Medicaid programs.

The administration has been trying to sell states on the merits of imposing block grants, or a per-person spending cap, without congressional approval. 

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Pallone wrote these changes would threaten access to health care for millions of Americans across the country, and are illegal.

“The plain language of the statute prohibits the Secretary from approving a waiver that requests a block grant or per capita cap in Medicaid through a cap on federal funds,” Pallone said. 

The Trump administration has pulled out all the stops to encourage red states to make controversial conservative changes to Medicaid, and Pallone questioned whether the agency would follow the law.

“It is troubling to learn that you are putting your radical agenda ahead of your responsibility to implement the law faithfully,” Pallone wrote.

A letter from the Centers for Medicare and Medicaid Services to state Medicaid directors currently under review at the White House Office of Management and Budget is expected to provide a road map to red states on how to gain approval from the administration on their requests to cap their Medicaid programs. 

Additionally, the administration has urged Alaska’s governor to apply to be the first state to change its Medicaid program funding to a block grant.

Imposing block grants in Medicaid has long been a major conservative goal. Republicans say policies like block grants and payment caps allow for more state flexibility and are more fiscally sustainable.

A block grant would transform Medicaid from an open-ended entitlement program into one with capped benefits. 

Currently, the federal government matches a certain percentage of state spending, and the funding is open-ended. In exchange, states agree to cover specific services and specific types of recipients.

Under a block grant, states would receive a fixed amount of money from the federal government, regardless of outside circumstances, that they could spend however they see fit.

Democrats argue block grants would result in Medicaid cuts. Depending on how the block grant is designed, it could also run into legal problems, based on coverage requirements.