Urgent Action Reminder: Congress Trying to Restructure Medicaid in Next 6 Weeks – Speak Up Now!

Dear TSE Stakeholders, 

please see the notice below that was sent to TSE employees to take action themselves and recruit support from others.
We hope you will take time to reach our to your Congressional members and stress that Medicaid restructuring is a HUGE concern. (See the bottom of this post if it’s all Greek to you!)

Click the “TAKE ACTION NOW” to go to an easy email form… you can also make a big impact by calling your Congressional delegations’ offices. To find phone numbers CHECK HERE for every state in the union.

Thank You in advance for your support!



Dear Lynne:

We are re-sharing this email because over the next six critical weeks Congress will be in session and actively seeking to restructure Medicaid as part of the ACA debate. It is important that you speak up now – the message below tells you how and links to action tools. 

We need your help, and we need it now. To begin with, a huge thanks to all of you who provided feedback that helped the ANCOR Board of Directors determine ANCOR’s 2017 Government Relations Principlesand our more specific position regarding block grants and per capita caps – set out further below. In short, the board voted to oppose Medicaid reform proposals that shift costs to states but to be open to proposals to improve services.

Here’s why we need to you to take action today: Congress is now back in Washington and the next 6 weeks are critical to the future of Medicaid. While the future of the Affordable Care Act (“ObamaCare”) is grabbing the headlines, the Republican-controlled Congress, with the House Leadership leading the charge, is adding Medicaid restructuring into the ACA Repeal  bill.

Whether it is called “Repeal and Replace”, or “Repeal and Repair”, Republican leadership wants to fundamentally reform Medicaid by converting it from an entitlement program to a block grant or per capita capped program. Although only rough details have emerged at this point, we can’t afford to wait for full details to amplify our message. This is the moment to reach out to all of your Congressional members to make sure they fully understand that IDD services are virtually 100% Medicaid dependent and the severe extent of the DSP workforce crisis.

In short, they need to understand the potential impact of any federal funding cuts on a system plagued by years of chronic underfunding.

As details unfold, we will share them with you, but we fully expect that we are going to be asking  you to become active repeatedly over the six weeks, and likely through the entire Spring. Please begin today by responding tothis action alert and sharing it with your networks.

Together, we can save our services! TAKE ACTION NOW!


The system of Medicaid funded community services for people with intellectual and developmental disabilities (I/DD) is under critical stress. Services for people with I/DD are inadequately funded and cannot address the growing direct support workforce crisis nor accommodate extensive waiting lists across the country while managing significant regulatory oversight and local, state, and federal mandates.

We do not support block grants which would end guaranteed access for millions of Americans with I/DD who are eligible for Medicaid services as a way to reduce federal funding resulting in shifted costs to states and state taxpayers. We do not support per capita cap proposals which would result in cost shifts to state governments, providers, individuals and families and without knowing details of how each state would reflect the cost of care or determine growth rates for the variation of people with disabilities served.

We believe there are opportunities to improve Medicaid. We support greater flexibility for states to innovate and provide higher quality care. If a proposal for either block grants or per capita caps is put forward that does not reduce federal funding, eligibility or services, then we are open to that discussion–or any discussion that focuses on ways to improve the lives of people with I/DD, and ensure both a stable workforce and a sustainable Medicaid program.


A note on what this all means…… (Thanks Dan!)

In the current system, anyone who meets program eligibility is entitled to the services.  Money is paid by the Feds  towards each person’s services.  In a block grant system, the state would get a set amount of money, and all services would have to be paid from that pot of money.  The selling point is that there would be fewer strings attached and the state would have more flexibility in how to spend it on services.
Here’s the problem.  If you take away the entitlement (the automatic funding), then future money would only increase if Congress approved an increase in the block grant.  So a small scale example.  Let’s say the state has 100 people in MA, each person receiving $50K in MA for a total of $5M.  If this were block granted, Minnesota would still receive $5M to spend on services. So far, OK – same amount of money for service.   Now let’s say that in the next year, 10 more people moved to Minnesota needing MA services.  Under our current system, the funding would be adjusted to account for the new service recipients, increasing the amount to $5.5M.  Under the block grant system, there would not be any new money to support the new people, so they would go unserved, or money would be taken from the existing services to cover the new ones.
The reason block granting is being proposed is that it will save money in the long run.  While the immediate impact seems to be equal dollars, every year that new people come into the system, the system will just have to absorb them.  Unless of course Congress approves an increase – not likely given the last 8-10 years of politics at the national level.
As you contact your legislators, it is important to emphasize this long-term effect of the proposed block grant system.  It will mean in a few short years, the State will be scrambling to make significant cuts in our services to provide for new enrollees.  With all of our current funding challenges, we can’t take this on, too!