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Medicaid: Matching Grants? Block Grants? Per Capita Cap? What does it all mean?

Medicaid, as we know it today, is a federal/state partnership that brings millions of Florida tax dollars back to the state to provide healthcare for Florida’s most vulnerable residents. Federal law requires states to cover certain groups of individuals including children, qualified pregnant women, seniors, and those who are disabled. States have the flexibility to cover additional groups.

The amount of dollars is based on the relationship between per person income in Florida versus the overall national average income. This means that when incomes decrease in Florida, the federal match increases. When incomes in Florida increase, the federal match decreases.

In its current form, Medicaid is a very difficult program to qualify for in Florida. In Florida, adults without dependent children do not qualify for Medicaid at any income level. Only parents of dependent children qualify for Medicaid in the sunshine state. Those parents can only make up to $6,738 a year (33% of the Federal Poverty Level*). Compared to other states, Florida’s eligibility levels ranks 47th.

Remember, Florida did not expand the Medicaid program under the ACA. This left approximately 800,000 Floridians without access to care.

Now, Florida wants to take our safety net for vulnerable, hard-working residents down another notch. Our state lawmakers are currently proposing to change the funding of the Medicaid program from “matching funds” system to “block grants” or “per capita caps”.

Under a block grant or per capita cap system the federal government would send a predetermined dollar amount to the state. If the economy gets bad, and more people qualify for benefits, no additional money will come from the federal government. If the amount of money to spend on the program stays the same and more people qualify, the government either spends less per person or makes eligibility rules even stricter than they already are.

More people will be left out altogether. This means that more people will end up in the emergency room once again.

Isn’t this the problem we have been trying to solve for so many years?

*Source: http://kff.org/medicaid/fact-sheet/where-are-states-today-medicaid-and-chip/#table3

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