Block Grants: Past, Present, and Future

During the House debate around repealing and replacing the Affordable Care Act (ACA), a provision was added allowing states to participate in an optional block grant for certain Medicaid participants. While the bill was pulled from the House floor, converting all or part of Medicaid into a block grant is not a new idea. Medicaid and other major open-ended mandatory programs, including the Supplemental Nutrition Assistance Program (SNAP), Supplemental Security Income (SSI), and child nutrition programs, have all been recommended for conversion into block grants in recent years.

This Issue Brief provides context for these and other proposals by examining block grants as a subdivision of federal grant funding. It also highlights recent proposals affecting block grants.