POLITICO's Pulse Check

Is this the next big change to Medicaid?

Episode Summary

The Trump administration has vowed to give states a chance to remake their Medicaid programs. One state is seeking permission to make one of the biggest changes of all.

Episode Notes

"Block grants for Medicaid" have been a conservative pipe dream and a progressive bogeyman for decades. Now Tennessee's GOP governor is moving forward with a plan to turn block-grant dreams into reality — if Trump officials and other lawmakers give permission.

First, Joan Alker of Georgetown's Center for Children and Families reviews how Trump officials and GOP leaders have changed the Medicaid program, why she blames the Trump administration for a recent spike in uninsured kids and why she's so worried about the Tennessee proposal. (Starts at the 1:55 mark.)

Then POLITICO's Rachana Pradhan joins Dan to review the policy and politics of block grants and how the Trump administration is sending mixed-messages to Republican states. (Starts at the 30:00 mark.)


Joan first appeared on "PULSE CHECK" in February 2017, to preview Seema Verma's possible tenure at CMS.

Children's uninsurance rose in 2018, the first uptick in years and a concerning change that Joan and colleagues predicted.

Current and former Trump administration officials — like Brian Blase and CMS Administrator Seema Verma — have argued that ineligible Americans are wrongly enrolling in Medicaid.

The Trump administration has steadily pursued a plan to allow states to seek block grants for Medicaid.

Tennessee had wanted to be the first state to win approval for a Medicaid block grant. Its GOP leaders rolled out their plan this week.

Law professor Nick Bagley argues that Tennessee's plan wouldn't be legal.