Democratic governors oppose plans shifting Medicaid expenditures toward states

Democratic governors have expressed their concerns about turning Medicaid into a block grant program, fearing that such a shift would cut access to care for enrollees. Issuing block grants would reduce federal support by providing a capped lump sum, requiring states to bear program costs that exceed the amount received.

Governors’ stance

Eleven governors have made statements opposing the reduction of federal commitment to their programs. A recurring theme appears: concern that this change will reverse the successes the programs have achieved in recent years. Virginia Governor Terry McAuliffe (D) rebuffed the idea that a block grant will allow programs to weed out inefficiencies, stating that the program runs efficiently as-is and that the block grant will result in a strained state budget, reduction of benefits, and limited choices. Louisiana Governor John Bel Edwards (D) noted that Medicaid provides most of the long-term care in the country, and that the aging population will require significant care in the future.

Some governors also mentioned their opposition to the idea of per-capita caps, which limits how much the federal government will reimburse a state per enrollee. Pennsylvania Governor Tom Wolf (D) also spoke about broad concerns surrounding replacing the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) and the potential impact on vulnerable residents who rely heavily on government-sponsored care.