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Canadian physician warns of Medicaid block-grant effects

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Roger Chafe,  M.D., an associate professor of medicine at Memorial University of Newfoundland, says  the Trump administration idea of replacing the current state-federal sharing of Medicaid costs with block grants to the states won’t work well. He says a similar system was tried and flopped in Canada. Among his remarks:

“Canada offers an example of some of the potential impacts a move to block-grant funding would have, particularly for state governments. For American advocates of expanding access to healthcare, Canada’s experience should be troubling.”

“Perhaps more concerning for state governments is that block grants offer the federal government an easier and quicker mechanism for reducing its contribution than could occur under any cost-sharing arrangement. Several times since Canada’s federal government moved to block grants, it has unilaterally lowered its contribution, leaving the provinces to deal with the consequences.”

“In the U.S., the burden of covering unexpected cuts in federal contributions would likely be borne by Medicaid recipients, who could face stricter program eligibility, higher co-pays or reductions in benefits; by providers, who could face reductions in reimbursements or increases in their costs for uncompensated care; or by state governments, through increases in taxes, reductions in other expenditures or increases in debt.”

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