Medicaid planning under President Trump: considering the coming changes, P.1

Medicaid is an important, even critical, resource for many Americans in paying for long-term care. The program, as readers may know, works jointly with the federal and state governments, assisting those with low income and few assets to pay for some or all of their care.

While the federal government sets eligibility rules for Medicaid, states have the ability to determine how they operate their own Medicaid programs. States are required to meet federal minimum requirements in terms of what they cover, but most states offer Medicaid benefits beyond the minimum. In its current form, Medicaid spending varies from year to year, with states spending more in difficult economic times.

With the recent election of Donald Trump, some are trying to predict what changes will be occurring with Medicaid, and how this will impact Medicaid planning. First of all, Trump has advocated “block-grants” for state Medicaid programs. A block-grant is simply an inflation-adjusted sum of money granted by the federal government to state governments, with only general requirements regarding how it is spent. Block-grants give states freedom to spend the money the way they determine is best.

Trump and his people argue that a block-grant system for Medicaid will result in less federal spending, as well as states offering more efficient health care. Trump also argues that block-grants will reduce fraud, waste and abuse, which is an enormous problem. Critics of block-grants, on the other hand, argue that there is no guarantee that states will spend the money to help those who need it most.

In our next post, we’ll continue looking at this topic, and why it will be important for older Americans in need of long-term care to work with an experienced attorney as changes in the Medicaid program occur.

Source: Quartz, “Donald Trump’s plan for Medicaid will cut health spending on the rural voters who elected him,” Tim Fernholz, Nov. 29, 2016. 

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