Trump’s Budget Proposal for Medicaid Changes

By Adam Cancryn with PoliticoPro

​The Trump administration is calling once again for a broad overhaul of Medicaid as part of its budget request — seeking to block grant funding and tighten eligibility standards through a series of changes that would cut hundreds of billions of dollars from the health program for the poor.

The proposal released today would eliminate Medicaid’s open-ended funding in favor of sending fixed grants to states or setting per-person caps, a major transformation that Republicans previously tried to push through as part of their failed efforts to repeal and replace Obamacare.

Critics have decried block grants and per-capita caps over fears they would slash states’ budgets for the program and limit access to health care. And with Democrats in control of the House, there is little chance Congress would approve any major changes to the program’s funding.

Still, the White House included it among the wish list of items in its fiscal 2020 budget, projecting that the change could save more than $386 billion over the next decade. It also backs a series of crackdowns on eligibility for the Medicaid program, including expanded work requirements and limiting the amount of assets or home equity that individuals can have and still qualify for Medicaid coverage.

Work requirements would save the federal government more than $130 billion over a decade, the administration predicted.

One other change included in the proposal would penalize Medicaid beneficiaries with a higher co-payment if they go to the emergency department for non-emergency care. That policy alone would save about $1.5 billion through 2029.