Tennessee on Tuesday became the first state to put forth a plan to turn Medicaid into a block grant – an idea long supported by conservatives to reinvent (some say rupture) the federal government’s 50-year-old agreement with states to pay for safety-net insurance for the poor.
Here we go again. We – and the 1.4 million Tennesseans enrolled in some form of TennCare – seem destined to be guinea pigs of Republican politicians pretending to be fiscal conservatives.
Gov. Bill Lee’s proposal volunteers the Volunteer State to seek a controversial federal Medicaid block grant waiver pushed by the Trump administration. Our supermajority GOP Legislature earlier this year passed a law requiring Lee to come up with such a plan. And in a nutshell, we will be the nation’s first test case of how far the Trump administration is willing to go to allow a state the “flexibility” on health care “entitlements.”
An explanation attached to Tennessee’s grant proposal says that the state can be “more flexible” and save money. But flexibility is code for what-can-we-not-cover. More on this later.
Because Trump and the Tennessee Trumpites in our state Capitol want to erase anything that hints at the Affordable Care Act, we’re going to trade in a TennCare waiver that lets the federal government off the hook for its ACA guarantee of a continuing 2-1 Medicare spending match. In its place, we’ll take a block grant that forever caps the amount of federal dollars we can use for Tennessee health care.