What Block Grants Are and What They Are Not

Rep. Timothy Hill, R-Blountville, proposed block grant legislation (HB 1280) as an innovative way to cover more Tennesseans through the state’s Medicaid program TennCare. However, a block grant is not Medicaid expansion. 

As the Tennessee General Assembly considers House Bill 1280 to apply for a block grant, it’s important to know the difference between Medicaid expansion and Medicaid block grants. Here are five facts about Medicaid block grants:

  1. Block grants are not Medicaid expansion, something a majority of Tennesseans (63 percent) support.
  2. Block grants will not close the coverage gap and cannot guarantee Tennesseans will gain more coverage. If the Republican-led Tennessee state legislature had expanded Medicaid five years ago in 2014, there would be no coverage gap in the first place. Medicaid expansion would close the coverage gap and guarantee coverage for the over 300,000 Tennesseans caught in the coverage gap.
  3. Zero of the 37 states (including DC) that adopted Medicaid expansion have switched over to block grants. Neighboring states like Kentucky, Virginia, and Arkansas know Medicaid expansion works.
  4. Rep. Hill argues that block grants are better than nothing because Republicans in the state legislature will never agree to expand Medicaid. This is a copout. There is no excuse to continually deny people health care when a solution is readily available.
  5. Block grants are not innovative nor a way for Tennessee to lead. Tennessee is one of 14 states that has still not expanded Medicaid. That’s not leading the country, that’s falling behind. It is irresponsible to experiment with an untested program when the health of Tennesseans are on the line, especially because block grants would take time to be approved by the federal government. Medicaid expansion is already approved, at our fingertips and there would be no waiting period.

HB 1280 is currently is in the Finance, Ways & Means Committee and is expected to pass. If passed by this committee, the bill will then be scheduled for a floor vote in the full House of Representatives for a floor vote.