Thursday, April 26, 2012


by e-mail from Medicaid in Schools |

Medicaid in Schools


Tuesday, April 24, 2012

Last Tuesday the House of Representatives approved Budget Committee Chair Paul Ryan's (R-Wis.) fiscal year 2013 budget proposal.

Ryan's budget plan would reduce overall Medicaid spending and convert the program to a block-grant system, in which states would receive a fixed amount of Federal dollars.  Under the Ryan plan, Medicaid block-grants would be capped at current spending levels for the next ten years. Block-grants mean fewer federal Medicaid dollars for special education and other school-based health programs, as they would be forced to compete with every other Medicaid program in a state.  A Medicaid system based on Federal block-grants would mean the end of Medicaid reimbursement dollars for school-based health and special education programs.Block-grants could provide Governors with some degree of flexibility in managing their own State Medicaid programs, but block-grants would also require the Governors to prioritize programs that would receive the limited Federal Medicaid funds.  Moreover, if the Affordable Care Act stands, States would not be allowed to change their eligibility standards after 2014, leaving them with no choice but to cut programs or raise taxes.  With or without the ACA, reimbursement for school-based health and special education programs would certainly be among the first to be cut.In addition to the Ryan budget plan -

    • 29 Governors openly support Medicaid block grants. 

    • Presumptive GOP nominee Mitt Romney supports block grants.

    • Rep. Todd Rokita, R-Ind., has introduced a bill to make Medicaid into a block grant program.

      Here is the reason for this email: School-based Medicaid reimbursement programs have only a small presence in state capitals and putting them in competition with all other state Medicaid programs would almost certainly eliminate their federal reimbursement.  We don't have the political clout to have much impact on the decision-making process on Capitol Hill or, if block grants become the law, in the various state capitals.  Joining with other groups who also oppose block grants - and there are many of them - could accomplish two things:  first, our combined strength might make a difference in Congress; and second, should block grants become the law of the land, we might have made some friends along the way who could stand with us in influencing states to continue to give school-based health programs access to Medicaid reimbursement dollars.  If you would like to be kept up to date on this issue, please send an email to  Please include your name and the name of your organization.  Your email address will not be used for any purpose other than to provide you with updates on the block grant issue.I may have met you at one of the many conferences we all attend or during our successful fight to overturn CMS 2287, which would have eliminated Medicaid reimbursement for school outreach programs.  This issue is no less critical.  Please join us in providing an online home for the collection and dissemination of information on the block grant issue.  Please feel free to share your thoughts with us so that we can pass them along.

      Gregory Morris

      Attorney at Law


      Medicaid in Schools

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