Let’s block grant Medicaid to better serve Tennesseans


November 13, 2019 11:42AM

I have many friends in D.C. who work on federal public policy. I don’t envy a single one of them. While it’s important to be in the heart of the fight, I prefer to keep my distance and focus instead on state-level solutions. After all, the states are the laboratories of democracy envisioned by our Founders. 

That’s why it’s normally a good idea to block grant federal programs to the states, where innovation and creativity can thrive. Properly structured, block grants can lead to better outcomes while spending fewer taxpayer dollars. Because of this, Beacon supports block granting many of the programs that are mostly federally funded but state-run, including Medicaid, as currently proposed by Gov. Bill Lee.

Block granting federal Medicaid dollars could allow Tennessee to provide better and more innovative services to those currently on our Medicaid program, known as TennCare. By utilizing our dollars more effectively, we can invest in solutions that expand access to quality healthcare to TennCare recipients. Too often, federal strings inhibit state-led innovation and efficiency. Block grants can alleviate this unnecessary pressure and top-down control. 

For example, if Tennessee is approved for a block grant as requested by Gov. Lee and the General Assembly, the state could explore expanding access to direct primary care for TennCare patients. This would allow them to enter into monthly agreements with their doctor for as little as $30-$40 per month, thereby giving them the ability to prioritize their preventative care in ways they’ve never had the opportunity to do before. 

Too often, patients turn to the emergency room only when they get sick. This is costly and bad for their long-term health. Giving TennCare patients access to a primary care physician and the ability to regularly visit for check-ups and other needs could transform their lives and allow them to take greater control over their healthcare decisions.

A TennCare block grant could also be used to expand access to services in rural parts of our state that are struggling the most. Tele-medicine and other innovative technologies could bridge the gap between rural TennCare patients and top-notch medical professionals who would otherwise be out of their reach.

These are just a couple of examples of how a TennCare block grant could improve the lives of Tennesseans enrolled in the program. And it could all be done with existing resources.

Due to the ability of the state to utilize existing Medicaid dollars in a more innovative and effective way, the Beacon Center supports Tennessee’s block grant approach as currently proposed. We hope that the Trump administration gives us the chance to pave the way for other states to reform their Medicaid programs to better serve both enrollees and taxpayers at the same time, not just in Tennessee, but across the entire nation.