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  • NASW-IL Staff

NASW opposes new Medicaid Block Grant Initiative

WASHINGTON, D.C. - The National Association of Social Workers (NASW) strongly opposes a new Centers for Medicare and Medicaid Services (CMS) block grant initiative that would undermine Medicaid, a federal program that for the last 50 years has helped millions of people with limited income and resources gain access to health care.

CMS on January 30 unveiled the Healthy Adult Opportunity (HAO) Medicaid demonstration program. States participating in this program would agree to receive the federal contribution to their Medicaid coffers through an up-front, lump-sum block grant instead of through open-ended matching funds.

CMS asserts that this demonstration program will promote innovation by states in how they implement Medicaid. However, these innovations could inadvertently include instituting work requirements, increased cost-sharing, and higher premiums -- all without federal approval and oversight.

“This ill-intended effort, which was not authorized by Congress, will allow the federal government to offload responsibility to states, and dramatically cut vital health care services for the most vulnerable: pregnant women, homeless adults and young people aging out of foster care,” said NASW CEO Angelo McClain, PhD, LICSW. “Communities of color, women, and LGBTQ individuals are also in jeopardy from the Administration’s latest assault on Medicaid.”

CMS is reaching out directly to states to advertise the HAO demonstration program. The CMS HAO Letter to state Medicaid directors misleads states by outlining potential savings from Medicaid block grants that could benefit state budgets.

Instead, a block grant structure is more likely to generate additional costs at the state level unless services are cut. Furthermore, the initiative allows states to set their own eligibility requirements for Medicaid, such as instituting “community engagement” requirements, increasing cost-sharing for enrollees, and limiting access to prescription drugs through restrictive drug formularies. These eligibility requirements will undoubtedly narrow Medicaid eligibility and create additional barriers to health care access.

Congress already rejected block grants in a failed 2017 attempt by the administration to repeal the Affordable Care Act. Court Challenges are expected to follow. NASW will continue to work to safeguard Medicaid and access to healthcare for all people.


The National Association of Social Workers (NASW), in Washington, DC, is the largest membership organization of professional social workers. It promotes, develops, and protects the practice of social work and social workers. NASW also seeks to enhance the well-being of individuals, families, and communities through its advocacy.

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