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New Plan Offering Block Grants to States

January 30, 2020

The Trump administration has released the Healthy Adult Opportunity plan that allows states to shift some Medicaid program funding to block grants. Under block grants, the federal government provides a set amount of funding to states for their Medicaid program and allows the states to determine how the funding is used for different coverage groups. Because the amount of funding is capped, Medicaid beneficiaries may not be able to access the services they need, and providers may be limited on the amount of services that can be provided.

ASHA’s 2020 Public Policy Agenda places a priority on advocating against public policies that would limit eligibility or access to Medicaid services. This program has the potential to limit that eligibility and access.


The Medicaid program was designed to fund health care services for the poor, elderly, and the disabled. Under Medicaid law, the federal government provides each state a percentage (roughly 50%-70%) of the cost to insure eligible individuals. Certain groups must be covered, and some minimum benefits are required but states have discretion to be more generous. As part of the Affordable Care Act, Medicaid was expanded. States are paid more to insure individuals whose income is slighter higher than allowed under the traditional Medicaid program. This plan was optional, and 36 states have expanded since 2014. 


Contact Laurie Alban Havens, ASHA’s director of health care policy, Medicaid and private health plans, at

ASHA Corporate Partners