WASHINGTON – Today, the Trump administration announced its plan to overhaul Medicaid by offering states the opportunity to receive funding under a block grant they have branded the “Healthy Adult Opportunity.” Currently, the federal government pays states a specific percentage of program costs. The proposal is a radical departure that would limit funding for state Medicaid programs and result in overall lower quality of care for people relying on the program. Nearly 72 million low-income and people with disabilities rely on Medicaid for health care they otherwise could not afford. APIAHF strongly opposes this plan and the implications it will have on the health of Asian Americans, Native Hawaiians and Pacific Islanders.

“The Trump administration has taken another opportunity to worsen the health of our country’s most vulnerable communities—including many Asian Americans, Native Hawaiians and Pacific Islanders,” said Juliet K. Choi, executive vice president of the Asian & Pacific Islander American Health Forum (APIAHF). “Despite claims to the contrary, encouraging states to adopt block grants will undermine the health of our most vulnerable—contrary to the intent of the Affordable Care Act’s Medicaid expansion and the Medicaid program itself. This is yet another attempt by the Administration to undermine Medicaid, weaken protections and reduce the quality of health care.”

Medicaid provides coverage for 1 in 5 Americans and is the primary source of health insurance coverage for those who are low-income. Under the current program, the federal government pays a set percentage of all costs incurred by states in providing services to all eligible Medicaid enrollees. Federal payments to states are guaranteed regardless of changing economic and social conditions, such as recessions, medical inflation, natural disasters and population aging. The block grant program will instead allow states to have a limit on how much federal funding they get for their programs, forcing cuts to either enrollment, the quality of coverage or the quality of care.

“We need to heed the cautionary tale of capped funding that communities in the U.S. territories are already experiencing,” said Choi. “Guam, American Samoa, the Commonwealth of the Northern Mariana Islands and Puerto Rico have had their Medicaid programs under a block grant with capped amounts. Access to health care lag behind national averages and the governments struggle to find adequate funding to provide for their residents. This is an inequity that needs to be fixed now, not replicated around the country by weakening protections and reducing care for vulnerable, low-income people.”

APIAHF will continue to analyze the new Medicaid block grant plan in the coming days.


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The Asian & Pacific Islander American Health Forum (APIAHF) influences policy, mobilizes communities, and strengthens programs and organizations to improve the health of Asian Americans, Native Hawaiians, and Pacific Islanders.