Several recent legislative efforts in Congress have included proposals that would cap the federal contribution (overall in a block grant or per person in a per capita cap) to Medicaid. Both a block grant and a per capita cap would shift costs to the states and reduce the availability and quality of long-term services and supports in both nursing facilities and home- and community-based settings.
MAINTAINING EXISTING MEDICAID FUNDING: Policy
Maintaining Medicaid funding
Congress and the states should ensure adequate funding of Medicaid and maintain existing guarantees for Medicaid long-term services and supports (LTSS).
Congress should not change the current financing of Medicaid to a block grant or a per-capita-cap both of which would shift costs and risks to states. Such a shift would severely undercut access to health care and LTSS (see also Chapter 7, Health: Medicaid).
Congress and the states should expand Medicaid to improve access to LTSS and ensure adequate federal and state Medicaid funding.