The Cancer Support Community (CSC), an international nonprofit organization that provides support, education, and hope to cancer patients, survivors, and their loved ones, opposes the Medicaid guidance announced by the Centers for Medicare & Medicaid Services (CMS) that allows states to convert a portion of their Medicaid program funding into a block grant program, and encourage CMS to retract this guidance.
This new guidance, titled Healthy Adult Opportunity, allows states to cap spending on the Medicaid expansion population, which, under the Affordable Care Act (ACA), granted Medicaid coverage to nonelderly adults with incomes up to 138% of the federal poverty level in states that chose to expand coverage. CSC opposes this effort out of concern that states will cut coverage completely for certain treatments or impose additional barriers to crucial services – making it more difficult for cancer patients to access the care and medications that they need. For instance, as the gap between the block grant and actual costs of care increases over time, states may feel increasing pressure to implement cost saving measures such as freezing enrollment and/or creating waiting lists, reducing benefits, or increasing cost-sharing for patients.
We are concerned that these changes are at odds with the intent and integrity of the program – namely to provide comprehensive health coverage to people whose income and resources are “insufficient to meet the costs of necessary medical services.” Section 1115(a) of the Social Security Act was created to allow the Secretary of the Department of Health and Human Services to waive certain provisions of the Medicaid program as long as the initiative is “likely to assist in promoting the objectives of the program.” This CMS guidance does not fulfil the requirement as it will create significant access barriers for low-income Americans.
Simply put, the core objective of the Medicaid program is to furnish health care to people living with limited incomes and this guidance undercuts this goal. Access to quality, comprehensive, and affordable health care is critically important for Americans living with cancer, and this guidance to encourage states to convert the funding structure of their Medicaid program to a block grant will jeopardize beneficiaries’ access to care.