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New CMS Block Grant Guidance Encourages States to Pursue Policies that are Harmful to People with and at Risk for Lung Disease

(January 31, 2020) - CHICAGO

For more information please contact:

Stephanie Goldina
[email protected]
312-801-7629

Yesterday, the Centers for Medicare and Medicaid Services (CMS) issued new guidance for state Medicaid programs on applying for block grants through Section 1115 demonstration waivers. Below is the statement of the American Lung Association in response to this announcement:

“The American Lung Association is deeply concerned about today’s announcement from CMS inviting states to block grant their Medicaid programs. Block grants would cause significant harm to the health and well-being of patients with lung diseases and other pre-existing conditions. Congress, which has authority over the funding structure of Medicaid, has repeatedly declined to pass legislation authorizing block grants, most recently during the debate over repealing and replacing the Affordable Care Act in 2017.

“Today’s guidance encourages states to pursue policies that would jeopardize patients’ access to care. States could adopt closed formularies that restrict prescription drug coverage, which would limit access to evidence-based care for patients with lung disease, including access to life-extending and life-saving new therapies for patients with lung cancer. States could continue to pursue work reporting requirements, even though a federal district court has vacated three waivers with these policies because of the threat they pose to coverage in the Medicaid program.

“The guidance also allows states to: 

  • Increase patient cost-sharing;
  • Eliminate important wraparound benefits, including providing transportation to help patients get to medical appointments;
  • Reduce oversight of managed care programs, including by changing network adequacy protections for patients;
  • Eliminate retroactive coverage and,
  • Make future changes to their programs without federal approval and input from stakeholders, including the patient community.

“All of these policies put patients’ care at grave risk.

“The American Lung Association will continue to protect patients with lung disease by opposing block grant proposals that states put forward under today’s guidance and instead champion full Medicaid expansion in all fifty states.”

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About the American Lung Association

The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease, through research, education and advocacy. The work of the American Lung Association is focused on four strategic imperatives: to defeat lung cancer; to improve the air we breathe; to reduce the burden of lung disease on individuals and their families; and to eliminate tobacco use and tobacco-related diseases. For more information about the American Lung Association, a holder of the coveted 4-star rating from Charity Navigator and a Gold-Level GuideStar Member, or to support the work it does, call 1-800-LUNGUSA (1-800-586-4872) or visit: Lung.org.

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