This issue brief from the Center for Budget and Policy Priorities describes how changing the current Medicaid program to block grants to states would shift costs to states, and ultimately result in millions of low-income and sick Americans becoming uninsured. Using a House Budget Committee proposal to reduce Medicaid funding by $1 trillion over the ten years between Fiscal Year 2017 and Fiscal Year 2026 with block grants, it is estimated that the states would experience a 25% reduction in federal funding over those ten years.
In order for states to balance their budgets, they would have to freeze/cap enrollments into Medicaid, limit the health care and services available, and/or increase cost-sharing requirements for Medicaid beneficiaries. All these policies would be permissible with block grants because Medicaid would no longer be an entitlement program. One estimate is that between 14 and 21 million Americans would lose their Medicaid coverage if block grants are implemented.