Block grants as federal funding are catching on for the purported flexibility they offer states, but there are downsides.
While an Affordable Care Act repeal could cost more than 300,000 Oklahomans their heath insurance, Republicans' plans for Medicaid could have drastic consequences as well. They're proposing block grants or patient caps for Medicaid to cut federal spending $1 trillion over 10 years
"Beltway Republicans will call this 'greater flexibility,' but with less federal funding, states basically have two options. They can contribute more of their own funding, which Oklahoma doesn't really have available, or they can use their flexibility that the caps come with to make cuts to eligibility, benefits and provider payments," said Oklahoma Policy Institute health and food security analyst Carly Putnam.
Block grants and patient caps would increase only for economic reasons, like inflation. States would not automatically get more money if they exhausted funding for an emergency like an epidemic.
Republicans are also considering block grants for states' Supplemental Nutrition Assistance Program funding.
"Block granting SNAP would essentially end SNAP. It would no longer be highly responsive to economic downturns and recovery or to natural disasters or rising food costs," Putnam said. "It also would allow states to shift funds to other programs — perhaps as a way to fill a persistent budget gap."
One in seven Oklahomans receive SNAP benefits.
Proposed cuts to federal safety net spending worry social service agencies. Though Oklahoma is among the top states in private giving, 94 percent of food assistance spending in the state is federal dollars. Block grant proposals call to reduce that.
Regional Food Bank of Oklahoma CEO Katie Fitzgerald said she has no confidence the state can close the gap, so people will go hungry.
"And that is going to further limit ability to work on those higher-order things that all of us want people to be able to do: Access education, be able to move forward and build the prosperity of their families," Fitzgerald said.
Gov. Mary Fallin has said she's receptive to proposals by congressional Republicans and President Donald Trump to convert funding for certain programs to block grants.
