Medicaid Block Grants in Texas

The Trump administration and Texas leadership continue to offer a block grant model as a more “flexible” form of the Medicaid program than the traditional model, in place since the program’s 1965 inception as part of Lyndon Johnson’s Great Society. Texas advocates of replacing traditional Medicaid with block grants are urging Texas leadership to pass a contingency Medicaid block grant act that will go into effect when a federal plan to block grant the program is in place and to lobby the Texas Congressional delegation to make block grants a priority. This posting explores block grant design and the impact of transforming Texas Medicaid to a block grant. I. Overview The current Medicaid program is a state and federal partnership that provides health care and long-term care services to very low-income Texans. The program is an entitlement, meaning it draws an open-ended federal match to states. Block grants will decrease federal health care funds going to states and will most