: State Hedges On Medicaid Grants
Republicans talk a lot about how Medicaid block grants could help governors bring down their costs, but they don't talk as much about what, exactly, the states would do with them. It's not that they have no answers. Gov. Haley Barbour of Mississippi has said he'd like to provide home-based care for children with special medical needs, rather than resort to more expensive hospital care, but federal rules get in the way. And a prominent conservative think tank says states could invest in money-saving systems if they had more funds upfront. But those changes most likely would get them only partly to the kind of savings Rep. Paul Ryan has proposed in his budget. And the other kinds of changes Republicans are eyeing are harder to talk about: stricter eligibility rules, benefit cuts, higher copayments for people with low incomes and lower payments to providers who already think Medicaid doesn't pay them enough (Nather 4/8).