The Trump administration is preparing to allow states to remodel their Medicaid programs with block grant proposals, according to a report from The Wall Street Journal, which cited people familiar with ongoing discussions.

The alleged reforms would align with proposals from Republicans to restructure Medicaid with block grants––which allow states to determine how to spend a predetermined set of funds––during their effort to repeal and replace the Affordable Care Act, the WSJ reported. States would still have to follow some requirements but would have more freedom to design their Medicaid programs and apply for waivers to further make changes.

Proponents of block grants argue the reform gives states more flexibility and helps lower costs. Opponents worry block grants could lead to less coverage for beneficiaries and more uninsured people.

CMS has reportedly considered issuing a guidance to allow block grants since the summer, according to the WSJ. The agency has already issued several guidances that allow states to circumvent some Obamacare requirements, including expanding short-term limited-duration health plans. CMS has also allowed a handful of states to implement work requirements for some Medicaid beneficiaries.

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