An in-depth look at how a Medicaid block grant would work

Kansas Health Institute News published a package of stories detailing how the block grant concept works, the pros and cons of this approach, and the history of such proposals.

Kansas Health Institute News: The ABCs Of Medicaid Block Grants
Kansas Gov. Sam Brownback, like other Republican governors, has asked federal officials to make Medicaid a block grant. Policy analysts say that could help cap federal health spending but would be a bad idea for Kansas or other states because they would be left to shoulder the growing costs of health care for the poor (Shields, 5/2).

The news service also details Block Grant Pros And Cons. In the piece, the pros are outlined by Michael Cannon, director of health policy studies at the libertarian Cato Institute, who has called "Medicaid a massive and irresponsible redistribution of the nation's wealth, shifting dollars from high-income states (such as New York) to lower-income states (such as Mississippi). ... The cons: But critics of the block grant idea, say the more likely results would be state taxpayers being stuck with the tab of ever increasing health care costs or major reductions in Medicaid services that would leave the poor with no good options for care" (5/2). A third article, Block Grants Over Time, notes that "the earliest federal block grants — the Partnership for Health in 1966 and Safe Streets in 1968 — were Democratic initiatives. Democrats then controlled Congress and the White House. Subsequent pushes for block grants have come mostly from Republicans. In 1971, President Nixon called for consolidating 129 programs into six block grants. Congress, still controlled by Democrats, rejected his plan. But by the end of the following Ford administration there were three new block grants, two of which have survived: The Community Development Block Grant and the Social Services Block Grant" (Shields, 5/2).

Related, earlier KHN story: How Medicaid Block Grants Would Work (Carey and Werber Serafini, 3/6).