“Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure.”
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Independently verified. After 2016, the Trump administration actively drove Medicaid block-grant policy on three fronts: (1) It championed the 2017 American Health Care Act (H.R.1628), which contained Medicaid per-capita caps and an optional state block grant beginning FY2020; Trump publicly endorsed letting states take a block grant, the bill passed the House on May 4, 2017, but the effort died in the Senate. (2) By executive action, CMS issued the 'Healthy Adult Opportunity' State Medicaid Director letter on Jan 30, 2020, offering states an optional block grant / aggregate cap via a Section 1115 waiver. (3) On Jan 8, 2021, CMS approved Tennessee's TennCare III 'aggregate cap' waiver, making it the first state permitted to convert Medicaid financing toward a block grant. This is active leadership well beyond a single supporting vote, but it fell short of the nationwide statutory block grant the promise implied: it was optional, never enacted by Congress, only one state was approved, and it was a modified/aggregate-cap variant later revisited under Biden's CMS. Hence CHAMPIONED (+0.75), not FULL. Party-neutral check: an opposing-party official with an identical record (House bill that died in the Senate + an executive framework + one state actually approved) would earn the same CHAMPIONED label.
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