Patient Groups Express Strong Opposition to New CMS Guidance on Medicaid Block Grants

New Guidance to Allow Block Grants or Per Capita Caps in Medicaid Would Harm Patients with Serious and Chronic Health Conditions

Today, the Centers for Medicare and Medicaid Services (CMS) issued new guidance for state Medicaid programs on applying for block grants or per capita caps through Section 1115 demonstration waivers. Twenty-seven patient and consumer groups representing millions of people with pre-existing health conditions issued the following statement:
“As patient and consumer organizations representing millions of individuals facing serious, acute and chronic health conditions, we are deeply concerned about guidance released today that invites states to apply for block grants or per capita caps for their Medicaid programs. In July, many of our organizations submitted a letter to CMS Administrator Seema Verma expressing strong opposition to such a policy.

“Per capita caps and block grants are designed to reduce federal funding for Medicaid, forcing states to either make up the difference with their own funds or make cuts to their programs that would reduce access to care for the patients we represent. As the gap between the capped allotment and actual costs of patient care increases over time, states will likely limit enrollment, reduce benefits, lower provider payments or increase cost-sharing for patients. States are already moving forward with deeply troubling proposals in anticipation of today’s guidance promoting these limiting financing arrangements.

“Simply put, block grants and per capita caps will reduce access to quality and affordable health care for patients with serious and chronic health conditions and are therefore unacceptable to our organizations. Our organizations will work to educate stakeholders at the federal and state level about the negative implications of today’s guidance and the need to protect patients with pre-existing conditions in the Medicaid program.”

Alpha-1 Foundation
ALS Association
American Cancer Society Cancer Action Network
American Heart Association
American Kidney Fund
American Liver Foundation
American Lung Association
Arthritis Foundation
Chronic Disease Coalition
COPD Foundation
Crohn's & Colitis Foundation
Cystic Fibrosis Foundation
Epilepsy Foundation
Family Voices
Hemophilia Federation of America
Leukemia & Lymphoma Society
Lutheran Services in America
March of Dimes
Mended Little Hearts
Muscular Dystrophy Association
NAMI National Alliance on Mental Illness
National Multiple Sclerosis Society
National Organization for Rare Disorders
National Patient Advocate Foundation
Susan G. Komen
United Way Worldwide
WomenHeart: The National Coalition for Women with Heart Disease

For more information, contact:

Allison MacMunn
312-801-7628
[email protected]

Fight For Air Climb - Columbus, OH
Columbus, OH | Feb 22, 2025
Fight For Air Climb - Cleveland, OH
Cleveland, OH | Mar 02, 2025