by Joseph Coletti
Senior Fellow, Fiscal Studies, John Locke Foundation
Tennessee is on the verge of seeking a block grant for Medicaid, the state-federal program that provides health coverage for children and their parents and long-term care for the elderly, blind, and disabled. The block grant would allow Tennessee to tailor Medicaid to the needs of its people, but federal funding would no longer be an open-ended promise. Instead, federal payments would rise with “population growth, medical inflation, and pharmaceutical costs.”
As Jordan Roberts and I recently wrote for the Daily Signal, state Medicaid programs have long relied on what Joe Biden called a “scam” to use ever more federal funds, and policymakers in North Carolina would use the scheme to expand Medicaid to childless working-age adults. The federal funds are so addictive, national policy experts cannot imagine that doing without them could provide better outcomes. The Wall Street Journal quoted Joan Alker, executive director of Georgetown University’s Center for Children and Families saying, “No amount of federal flexibility is worth the loss of federal dollars.” It leaves one to wonder if Alker thinks federal dollars have any cost.