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America’s Frontline Physicians Oppose New Federal Guidance on Medicaid

  • January 30, 2020

Washington, DC — Representing more than a half-million of America's frontline physicians and medical students, leaders from six major medical organizations—the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians, the American Osteopathic Association and the American Psychiatric Association—issued the following joint statement opposing new guidance issued by the U.S. Centers for Medicaid and Medicaid Services (CMS):

“The CMS guidance issued today fundamentally alters the Medicaid program in a way that disproportionately burdens states, threatens the public safety net and makes it more difficult for our patients to get the care they need. By giving states the option to pursue block grants and per capita caps for low-income adults in Medicaid, including parents, CMS has undermined the adaptability of Medicaid’s current federal-state partnership. Doing so makes it more likely that a devastating public health crisis like the current coronavirus outbreak could completely deplete funding for the program. As we’ve seen in Puerto Rico, a block grant model leaves states and localities much more vulnerable to unpredictable events like natural disasters when more people need to enroll in the program.

Block grants and per capita caps have a singular purpose: to reduce federal funding to states. These drastic changes to Medicaid threaten to force states to choose between cost-saving measures like eliminating benefits, implementing waitlists, reducing eligibility, or cutting payments to physicians and other clinicians when federal funds run out. These policies stand in the way of patients’ affordable access to needed care.

With the limited funding available in a block grant and through per capita caps, states will be left facing impossible decisions when federal funding runs out, like whether to cut benefits, restrict eligibility, use waitlists, or cut already low physician payments. Today’s guidance invites states to pursue policies that will leave patients worse off, including limiting how many prescription medications are available and cutting critical benefits, even before federal funding runs out.

A block grant or per capita cap financing mechanism for Medicaid violates our joint principles on Medicaid waivers. We strongly urge CMS to rescind this guidance and instead advance policies that support and strengthen Medicaid.”

About the American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 38,500 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information please visit

About the American Academy of Family Physicians

Founded in 1947, the AAFP represents 134,600 physicians and medical students nationwide. It is the only medical society devoted solely to primary care. Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care. To learn more about the specialty of family medicine, the AAFP's positions on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit For information about health care, health conditions and wellness, please visit the AAFP’s award-winning consumer website,

About the American Academy of Pediatrics

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds.

About the American College of Physicians

The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 154,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter, Facebook, and Instagram.

About the American College of Obstetricians and Gynecologists

The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation's leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women's health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion.

About the American Osteopathic Association

The American Osteopathic Association (AOA) represents more than 145,000 osteopathic physicians (DOs) and osteopathic medical students; promotes public health; encourages scientific research; serves as the primary certifying body for DOs; and is the accrediting agency for osteopathic medical schools. To learn more about DOs and the osteopathic philosophy of medicine, visit


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