Impact of Block Grants and Per Capita Caps on Medicaid Enrollees: State Fact Sheets

For more than 50 years, Medicaid has served as a critical safety net and lifeline for over 70 million Americans. This includes more than 17 million children and adults with disabilities and low-income seniors, many of whom need health care and long-term services and supports (LTSS) - including help with eating, bathing, dressing or managing finances- to address their daily needs. Financed by both the federal and state governments, Medicaid guarantees health and LTSS coverage for all eligible individuals and families.

Under the current system, federal funding increases in response to increases in enrollment, service costs, and use. Some policymakers have recommended that federal financing be limited, either by providing states annually with a fixed amount—a “block grant”— or by providing a set amount per beneficiary—a “per capita cap”—for their Medicaid programs. While block grants and per capita caps are related but different concepts, both could end Medicaid’s guaranteed access to care. They could also shift costs over time to both states and to Medicaid enrollees, many of whom simply cannot afford to pay more for their health care or LTSS needs.

The fact sheets on this page show the potential implications of capped Medicaid financing for health and LTSS across all populations, including low-income seniors and individuals of all ages with physical, mental health, intellectual, or developmental disabilities.