1. The Long-Term Care Discussion Group
Of Block Grants & Waivers: What Medicaid Changes Could Mean for Long-Term Services and Supports
The Long-Term Care Discussion Group
Judith Solomon
April 24, 2017

2. And Federal Spending Cuts Would Grow Over Time
Medicaid Spending Cuts in House GOP Plan Would Total $839 Billion Over 10 Years
And Federal Spending Cuts Would Grow Over Time
To download graphic, see

3. Federal Medicaid Per Enrollee Spending
Capping Rate of Growth in Medicaid Spending Per Enrollee Leads to Severe Cuts Over Time
Federal Medicaid Per Enrollee Spending
Sources: CBPP analysis of BLS and CBO data

4. Medicaid Per Capita Cap Would Shift Costs to States in Three Ways
Cuts Federal Funding Over Time
Explicit cuts in funding based on structure of the cap:
Baseline funding cap per beneficiary is set too low
Rate of growth in spending per enrollee doesn’t keep pace with health costs
Unanticipated increases in expected state Medicaid costs
Increases in health care costs that will likely occur, but are not factored into the established growth rate

5. Medicaid Long-Term Services and Supports (LTSS) Users Accounted for Nearly Half of Medicaid Spending, FY 2010
Enrollees
Expenditures
57%
94%
22%
Comment/Question: 2%
21% 4%
Total = 66.4 million
Total = $369.3 billion
NOTE: Individuals who used both institutional and community-based services in the same year are classified as using institutional services in this figure.
SOURCE: KCMU and Urban Institute estimates based on data from FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 reports. Because the 2010 data were unavailable, 2009 data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.

7. Judith Solomon
@JudyCBPP