The Medicaid Block Grant; Who Will Suffer?

The Medicaid Block Grant; Who Will Suffer?

Assault on Medicaid – The Block Grant Edition

By Lexi Amos, Parent advocate for children’s rights
Published in Missouri Autism Report, March/April 2017 edition

In January, Missouri Senator David Slater (District 29: serving Barry, Lawrence, McDonald, Stone, and Taney Counties) introduced a bill that would change the financial structure of Missouri Medicaid (Mo HealthNet) into a dangerous block grant system.

Missouri’s current Medicaid program is a partnership between the state and federal governments, funded partially by the federal government and partially by the state of Missouri. For every dollar that Missouri spends, the federal government spends $1.72. In the current system, if the cost of providing Medicaid services is more than expected, the federal government provides assistance to the state.  The current funding system accounts for events such as epidemics, economic downturns, and natural or man-made disasters –  all possible reasons a state might exceed their expected Medicaid costs.

A block grant system would drastically change the funding structure of Medicaid. Under a block grant, the federal government provides only a pre-set amount of funding for our state’s Medicaid program. If Missouri’s Medicaid program exceeds our federal funding, our state is responsible for all of the excess costs. This would require our state government to either increase taxes to cover the healthcare costs or limit the coverage and services available to Medicaid participants.

Jen Bersdale, Executive Director of the patient advocacy group Missouri Health Care for All, said “Senate Bill 28, as currently written, would hand complete control of our state’s Medicaid program over to a small administrative committee with no actual accountability to voters”. And legal experts Joel Ferber and Geoff Oliver, with Legal Services of Eastern Missouri, found that 243,000 to 357,000 Medicaid recipients would lose coverage under a Medicaid block grant.Block Grants & CPP WHO LOSES UNDER SB28-

We know how important disability Medicaid is to the lifetime success of many people with disabilities, and we must work with our legislature to ensure that Medicaid is a sustainable assistance program well into the future. However, a block grant is not the solution we are looking for. By changing the current federal-state cost share to a block grant program Missourians are providing a “legal” avenue of denying medical coverage to people who qualify and depend on government assistance programs.

In our state’s difficult economic climate, it is unlikely our state government will raise taxes or other revenue to cover the funding gaps a Medicaid block grant would cause. It is much more likely that integral services would no longer be covered, care would be rationed, and hundreds of thousands of Missourians would be completely cut off from Mo HealthNet. Bottom line, if we are not diligent in monitoring and protecting our access to quality health care and safety net systems, our elected officials may dismantle the programs our families and neighbors depend on.

If you would like to get involved and share how block grants would affect you or people you care about please contact Crystal Brigman Mahaney, with Missouri Healthcare for All at 417-693-5690 or email at

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