HHS Secretary Alex Azar said his department and some states are in ongoing discussions about transforming Medicaid into a block grant program without the approval of federal lawmakers, The Hill reports.
"We have discussions with states where they will come in and suggest ideas," Mr. Azar told Sen. Bob Casey Jr., D-Pa., during a Senate hearing March 14, according to the publication. "There may be states that have asked about block granting, per capita, restructurings around especially expansion populations ... It's at their instigation."
Medicaid has long been an open-ended entitlement. But President Donald Trump's administration announced in January that it was working on a plan to allow states to receive fixed federal block grants for Medicaid spending.
Conservatives have suggested a Medicaid block grant program for years, and the issue was discussed in 2017 amid Republican efforts to repeal the ACA.
States could potentially be allowed to institute Medicaid block grants without congressional approval if they received a federal waiver, according to The Hill. But the publication notes this would be disputed and could spark challenges in court.
Mr. Azar did not indicate how many states his department was in discussions with regarding the issue.
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