off the charts
POLICY INSIGHT
BEYOND THE NUMBERS
BEYOND THE NUMBERS
Why Rhode Island’s No Model for a Medicaid Block Grant
The budget that House Budget Committee Chairman Paul Ryan (R-WI) will unveil next week is expected to propose converting Medicaid into a block grant. Some block-grant proponents cite Rhode Island’s Medicaid program, which operates under a federal waiver with capped federal funding, as evidence that all states would do well under a block grant, claiming the waiver has saved the state over $100 million.
But a recent independent report that Rhode Island Governor Lincoln Chafee commissioned shows that the state’s savings under the waiver were unrelated to the federal funding cap and mostly reflected a large influx of new federal dollars. Our new paper highlights some of the report’s findings:
- The waiver did not save the state $100 million over 18 months, as block-grant proponents claim, but $23 million over three years. These savings resulted from policy changes that required a waiver, but not one with a federal funding cap.
- A much larger chunk of the state’s savings under the waiver — $42 million — result from a waiver provision that allowed Rhode Island to claim federal matching funds for certain health services that the state had previously paid for.
- Since the waiver took effect, Rhode Island has also saved $32 million by making Medicaid changes that have nothing to do with the waiver; any state can make them under current federal rules.
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