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Block grants for Medicaid program not so simple

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TALLAHASSEE, Fla. – Gov. Rick Scott and Republican legislative leaders have touted the possibility that President-elect Donald Trump's administration could usher in block grants for the Medicaid program.

The basic idea is that Washington would send money to the states, which would then have flexibility to run Medicaid as they see fit.

But it might not be that simple.

Justin Senior, secretary of the Florida Agency for Health Care Administration, told senators Thursday that a key question involves how the federal government would distribute money in a block-grant system.

If the money is distributed on a per-capita basis, Florida might be in good shape. But if it is based on factors related to current Medicaid spending, Florida might not do so well. Senior said Florida has run its Medicaid program more efficiently than other states and shouldn't be penalized for that.

"It's very important to us if you do it on a per-capita basis or on an overall basis that we be treated fairly," Senior told the Senate Appropriations Committee.

Senate President Joe Negron, R-Stuart, said last month he wants the Senate to begin working on a "framework" for the state's Medicaid program under a block grant. In such a situation, Senior said Thursday he thinks the state should continue with a model that uses managed-care plans.

But at this point, the discussion is somewhat theoretical as Trump has not taken office and shifting to block grants would require congressional and regulatory approvals. Democrats also likely would object, arguing in part that moving to block grants could lead to cuts in services.