The future of Medicaid looks to be a top priority under President Trump and a Republican Congress. During the campaign, Mr. Trump and House Speaker Paul Ryan (R-WI) called for replacing the current Medicaid program — and the ACA-mandated expansion — with a block grant to states or per capita spending caps. Neither offered details, so it’s difficult to understand how their proposals would work or their impact on programs operated currently under waivers.
The Trump administration is also expected to give states more control over the program, perhaps allowing them to require beneficiaries to pay premiums and co-pays and to impose work requirements.
Watch for details as Republican leaders develop their plans in the weeks ahead. Regardless of what they propose, they are expected to have the votes to pass something. (John Flink, WSHA federal lobbyist)