Rhode Island: The Test Case That Never Was for Medicaid Restructuring

By Edward Alan Miller
Professor of Gerontology and Public Policy
McCormack Graduate School

Although ultimately withdrawn before a vote, the American Health Care Act (AHCA) proposed by House Republicans would have radically restructured Medicaid by converting the federal government’s open-ended commitment to match state government spending with a per-capita cap on the amount of money a state could receive for each enrollee. An alternative to per-capita caps, Medicaid block grants, is also favored by some Republicans but was not included in this particular proposal. Block grants would replace the federal government’s open-ended financial commitment with a fixed up-front annual allotment for the entire covered population.

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