Tennessee Seeks to Become First State to Convert Medicaid to a Block Grant

The Tennessee State Capital.

The Tennessee State Capital. Shutterstock

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STATE AND LOCAL ROUNDUP | Mayors from across the country endorse Buttigieg … South Dakota governor addresses flooding … Minnesota governor questioned about deleted video.

Tennessee Gov. Bill Lee announced a plan this week to convert the state’s Medicaid program into a block grant, which, if successful, would make the state the first in the nation to do so. Under a block grant system, the federal government would no longer cover a portion of the state’s healthcare costs for eligible people, but would instead distribute a block of money to the state to spend how they choose. Lee, a Republican, said that the plan could save Tennessee $1 billion, and would be an example for other states that want to pursue the same option. “It would be very important for the country to see an opportunity to lower the cost of Medicaid services without changing the quality or level of those services to the Medicaid population. For Tennessee to be an example of how we can deliver that would be a very big deal,” Lee said. The state estimates that around 1 million people on Medicaid,  which largely covers poor families and children, would be affected by the change. The state has not expanded Medicaid under the Affordable Care Act. A block grant model would exempt the state from following many set Medicaid rules regarding who is eligible for coverage and what healthcare services are paid for, but Lee said his plan will not cut back on benefits or eligibility rules. President Trump has been supportive of the idea of Medicaid block grants in the past, and ultimately, Tennessee's plan would require federal approval. In July, a group of 27 nonpartisan health organizations, including the American Cancer Society, urged the Centers for Medicare and Medicaid Services to reject any state plans for block grants, saying that the switches would “have widespread negative impacts on state economies...as many critical healthcare entities, such as children’s hospitals, rely on Medicaid financing for their financial stability,” and would force states to make cuts to their Medicaid programs. “Simply put, block grants and per capita caps will reduce access to quality and affordable healthcare for patients with serious and chronic health conditions and are therefore unacceptable,” the group wrote. [Washington Post; Tennessean]

MAYORAL ENDORSEMENTS | Fifty-eight mayors and former mayors from across the country signed on to a joint op-ed this week endorsing Pete Buttigieg, the mayor of South Bend, Indiana, in his candidacy to become the Democratic nominee for president in 2020. The group wrote that mayors don’t treat politics like “a blood sport,” making a local government leader their ideal choice to overcome partisan divides. “While inaction and gridlock are the norm in Washington, mayors don’t have the option to kick the can down the road. Our residents expect electricity when they flip the switch, clean water from their taps and trash picked up regularly,” the mayors wrote. The most high-profile mayors to sign the letter include Dayton Mayor Nan Whaley, who has publicly clashed with President Trump following the recent mass shooting in her city, and Austin Mayor Steve Adler. The letter was also signed by nine mayors from Buttigieg’s state of Indiana. Politico pointed out that most of the mayors who signed on to the letter are white, a potentially troubling sign for Buttigieg, who has polled at less than 5% among black voters and less than 2% with Latinos in some states. [USA TODAY; Politico]

SOUTH DAKOTA FLOODING | South Dakota Gov. Kristi Noem toured eastern parts of the state this week to survey the damage from extreme weather events, including flooding, severe storms, and tornadoes. South Dakota has seen precipitation 400% above average in the first two weeks of September, causing major highway closures and widespread damage. "We've had dams fail and culverts that have been blocked by floating one-ton bales of hay. We've had sections of state highways wash away overnight, and vehicles fall into the rushing water...We are living history right now... But like I said earlier this year, the storms are strong, but South Dakotans are stronger,” she said. Noem has requested $56 million in federal aid for cleaning up after the storms. In the meantime, many farmers in rural areas of the state are struggling with lost crops and flooded farms. "What's crazy is we saw water like this already this spring, and that was way beyond anything anybody had seen. Now, six months later, it's all water again. It's almost Biblical out there,” said farmer Jim Petrik. [KSFY; United Press International]

DELETED VIDEO | Minnesota Gov. Tim Walz is responding to allegations that his administration attempted to cover up an incident in which his wife, first Lady Gwen Walz, stumbled while talking about race on a panel about prison reform. In May, Gwen Walz spoke on a panel regarding prison reform, and when asked about the racial disparity in the state’s prison population by moderator Toussaint Morrison, the two engaged in a “testy” exchange. “In discussing the institution of prison, to my surprise, most of the panelists had neither an objective nor subjective answer to questions regarding racial disparity, an undeniable component throughout the United States history of crime and punishment,” Morrison said. After the event, members of Walz’s administration allegedly asked the group hosting the panel to delete the footage, which they did. Walz, a Democrat, contends that this was because they did not have signed releases from attendees. “The first lady is out there talking about prison reform and race. That is going to be controversial. I was not at the event or part of this. But I certainly support their decisions they made,” Walz said. But Republicans have said that the behavior follows a pattern. “If there is a theme for Governor Walz’s first year in office, lack of transparency comes to mind,” said Minnesota Republican Party Chair Jennifer Carnahan. [Minnesota Public Radio]

CHILD PORN | Pennsylvania state Sen. Mike Folmer resigned this week after being charged with possession of child pornography. Pennsylvania Senate President Pro Tempore Joe Scarnati and Senate Majority Leader Jake Corman, both Republicans, said they immediately asked Folmer, also a Republican, to resign.“We are sickened and disturbed by the charges brought against Mike Folmer yesterday. We have reviewed the criminal complaint and spoke with Mike Folmer early this morning to insist on his resignation from the Senate,” they said. Pennsylvania Gov. Tom Wolf, a Democrat, said that Folmer’s behavior was “beyond comprehension” and that Folmer had taken advantage of the people who elected him. “We elect leaders to serve as a voice for those who do not have the ability to advocate for their own needs, demanding that they will protect our children, families, and communities,” Wolf said. Folmer told investigators that he got the images through his Tumblr blog and was dealing with “personal problems/issues.”  [Patriot-News; Washington Post; CBS Pittsburgh]

Emma Coleman is the assistant editor for Route Fifty.

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