A couple of days ago CMS released guidance encouraging states to ask for Medicaid waivers that would block grant the services “able bodied adults”.  The block grant would come with increased flexibility about how to spend those federal dollars and what services to provide- but would cap federal funding for that portion of the program. They’re branding the initiative the Medicaid Healthy Adult Initiative.

Here’s the letter that CMS sent to the State Medicaid Directors and their ”Fact Sheet”.

It’s an optional program, so governors will have a choice whether to take the bait or not. I haven’t seen any media responses from our governor about whether he’s interested in such a new block grant waiver. The Oklahoma governor already directed his state health department to begin the waiver application work.

Also, as is standard operating procedure these days it seems, it’s likely that a state or group of states will sue CMS in federal court challenging their authority to approve such waivers – likely arguing that CMS doesn’t possess the authority to do this under the existing law.