Tennessee block grant ‘a much better way’ than Biden Medicaid spending plan, Blackburn says

By | April 18, 2021

Tennessee Republican Sen. Marsha Blackburn criticized the Biden administration’s push to expand Medicaid as a means of improving rural access to healthcare, arguing instead for a block grant financing system endorsed by conservatives for its potential to lower state spending.

“I think Tennessee actually went about this the right way,” Blackburn told the Washington Examiner. “Basically, the state will be able to use the federal funds and keep part of what they’ve been saving the federal government.”

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Tennessee became the first state to receive federal approval for its Medicaid block grant program in January. Medicaid is the federal health program aimed at providing care for the very poor or disabled. Under the approved waiver, Tennessee would get an annual grant from the government to spend on state health services under TennCare, the state’s Medicaid program. The plan also allows for increased funding if there are unexpected increases in enrollment.

Biden, meanwhile, proposed financial incentives in the American Rescue Plan enacted last month to encourage the states that have not expanded Medicaid under Obamacare to do so. The plan offered a temporary 5-point increase in the Federal Medical Assistance Percentage, or the specified percentage of Medicaid program costs the federal government will cover. The plan also gave states the option to expand Medicaid to cover pregnant and post-partum women for one year after giving birth, as well as incentives to strengthen home and community-based health services under the state Medicaid program.

Tennessee’s block grant approval under former President Donald Trump may not survive President Joe Biden, who has the power to rescind the waiver. Biden has opposed Medicaid block grant funding in the past over concerns that states could limit the range of health services covered and who could get coverage.

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Still, Blackburn said that Tennesseans support the kind of spending flexibility that a block grant program provides.

“Our state legislators working with local officials will do a better job of figuring out how to best provide healthcare in our communities,” Blackburn said. “Quite honestly, a lot of our state legislatures and our local mayors and governors are ill and fatigued of having the federal government dictate to them how to run their communities.”


Soon after the passage of the American Rescue Plan, Biden unveiled the $ 2 trillion infrastructure package known as the American Jobs Plan that included provisions for expanding access to healthcare services in remote areas. Republicans have bristled at the idea of approving another massive spending package so soon after the American Rescue Plan was enacted.

Many crucial details about funding the healthcare proposals in the infrastructure bill remain unclear. For instance, Biden included an ambitious proposal to invest $ 400 billion in reforming the home caregiving industry without offering more details about how that funding would be distributed.

“We want to be sure we know exactly how this money can be spent before we spend a dime,” Blackburn said. “There have been too many times, the state would spend it, and then they were told, ‘Oh that’s not the outcome we wanted.’”