The Trump Administration is focused on pushing states to accept block grants for Medicaid which would cap the amount of Federal dollars being spent and leave more discretion up to the states to implement Medicaid programs. Currently, Medicaid is funded by both the Federal and State governments and currently, Medicaid funding is open-ended, meaning the Federal government matches State spending. If that funding is converted to a block grant, a state could get a limited, lump sum of Federal money instead. Because Medicaid pays for a significant amount of long term care costs, there is a concern that the quality of such care would be jeopardized if at least some states are given too much discretion to comply with federal regulations.
The link for the WSJ Article on this issue is set forth below.
https://www.wsj.com/articles/trump-administration-to-soon-issue-guidance-on-medicaid-block-grants-11579438800?mod=searchresults&page=1&pos=4