Gov. Bill Haslam Looks Forward To More State Control Over Medicaid Spending

Nov 21, 2016

Conservatives have pressed for states to be given more control over how federal tax dollars are spent — especially on big programs like Medicaid — with little success in recent years.

But Tennessee Gov. Bill Haslam is getting excited that a breakthrough may be about to happen, now that Republicans are gaining control of the White House, in addition to Congress.

They're called "block grants" — large chunks of cash that the federal government would hand to the states to spend on social programs, with few strings attached.

Haslam has been a fan of them since before he came into office six years ago. And he says he discussed block grants for Medicaid when he met up with Vice President-elect Mike Pence at a recent Republican governors meeting.

"Forget your politics," he said in a speech Monday to the Downtown Nashville Rotary Club. "The federal government is so large now that it truly is unmanageable. And I honestly think that breaking it into pieces and letting states that can focus on things better will produce better results."

Pence, who is currently serving as the governor of Indiana, indicated Donald Trump's administration is seriously considering block grants, says Haslam.

That's a big change from a few weeks ago, when block grants still seemed like a pipe dream. Democrats, including President Obama and Hillary Clinton, have feared that states would use block grants to cut their own spending on health care, leaving the poor worse off.

Haslam says governors will still have to protect services for the most vulnerable for block grants to work. But the incoming Trump administration seems far more likely to accept those assurances.