Both Medicaid and CHIP should remain as they are rather than changing one program to be either entitlement or block grant. If Medicaid is turned into a block grant or CHIP into an entitlement program, the move would lead to far reaching adverse consequences since Medicaid covers many more of the nation’s children ( Guyer, Heberlein & Alker, n.d) . The Medicaid should not be capped into a block grant due to the uncertainty surrounding its allotment structure which has made many states to hesitate moving forward to include more uninsured children. If Medicaid was turned into a block grant or CHIP into an entitlement, it would lead to major errors such as the problems that have plagued the CHIP during lean times such as waiting lists and other forms of rationing ( Guyer et al., n.d) . A combination approach of Medicaid and CHIP would lead to arbitrary caps on federal funding thereby affecting service delivery.
Turning Medicaid into block grant for example would make states presumably unable to increase spending at a similar rate that has occurred on CHIP. As Park and Broaddus (2011) explain, the resultant outcome would be counterproductive characterized by deep funding cuts consequently leading to shutting down on enrollment, limiting the scope of coverage and shifting the healthcare cost burden to families which would affect them adversely. Converting either Medicaid into a block grant or CHIP into an entitlement program would reverberate problems more deeply into the United States care system since both serve different roles in the healthcare coverage.
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Integration of Medicaid and CHIP would increase federal government spending with an additional $514 billion hence costing tax payers more money (Haley, Wang, Buettgens & Kenney, 2017). The primary goal of Medicaid is to cut the federal government spending, an objective that would be compromised if a combination approach is adopted. Turning Medicaid into a block grant or CHIP into an entitlement program would make eligible children be turned away from insurance coverage. Changing one program to be either entitlement or block grant is therefore not a viable option in the current fiscal environment in the United States.
References
Guyer, J., Heberlein, M., and Alker, J (n.d). CHIP: Not a Model for a Medicaid Block Grant, https://ccf.georgetown.edu/wp-content/uploads/2012/03/Federal%20medicaid%20policy_CHIP-not-a-model-for-block-grant.pdf
Haley, J., Wang, R., Buettgens, M., & Kenney, G. M. (2017). Health Insurance Coverage among Children Ages 3 and Younger and Their Parents.
Park, E., & Broaddus, M. (2011). Medicaid Block Grant Would Produce Disparate and Inequitable Results Across States.
