“Block-grant Medicaid to the states. By block-granting Medicaid to the States, those with the most need will be served best by those who know the target population best.”
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Trump backed the 2017 American Health Care Act (H.R. 1628), which would have converted federal Medicaid funding to per-capita caps with a state block-grant option; it passed the House 217-213 on May 4, 2017 but died in the Senate, as did the Graham-Cassidy block-grant plan that September. His administration then pursued the goal administratively, issuing 'Healthy Adult Opportunity' guidance in January 2020 and approving Tennessee's aggregate-cap TennCare III demonstration on January 8, 2021 — a modified block grant for a single state. Medicaid was never block-granted nationwide, including in his second term through July 2026, so this was a genuine, sustained attempt that did not land.
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