Webinars Series:

Alaska Medicaid Block Grant Information Sessions


Alaska is exploring whether to change its Medicaid program by adopting a block grant approach in which the federal government would provide a set amount of money rather than providing federal dollars that match what the State spends.  

Because this is a change that could impact Alaska Mental Health Trust beneficiaries and the providers of services to these beneficiaries, the Trust is sponsoring three webinars designed to allow for a more informed discussion about how a block grant program can be implemented.

Two former federal Medicaid high-level officials will provide information and answer questions at all three sessions. Full bios for the speakers can be found at the bottom of this page. 

  • Dennis Smith was in charge of Medicaid for the federal government under both terms of the George W. Bush administration. In his capacity as head of Medicaid, he negotiated Section 1115 Demonstration Projects with more than half of the states.
  • Andy Schneider was advisor on Medicaid under the Obama administration. Andy has written extensively on Medicaid issues and led the development of the Medicaid Resource Book (2002) for the Kaiser Commission on Medicaid and the Uninsured.

The sessions will be moderated by Steven Lutzky. Steven has extensive experience designing, implementing and evaluating home and community-based systems for older adults, individuals with disabilities and long-term illness for the federal government, states, and private sector clients. He served as the Director of Division for Advocacy and Special Issues (DASI), within the Disabled and Elderly Health Program Group, Center for Medicaid and State Operations (CMSO), Center for Medicare and Medicaid Services (CMS). Steve has also served as the Chief of the Office on Disabilities and Aging within the District of Columbia’s Medical Assistance Administration and was a Senior Manager with The Lewin Group. Steve currently serves as the President of HCBS Strategies.

Each session will include approximately 30 minutes for presentations, followed by one hour for questions and answers. The topics for the three sessions are:

Session 1


Medicaid block grants 101

Watch the full presentation video and audio

Download the presentation slides

July 18, 2019, 9:30-11:00 am

This session will provide an overview of Medicaid block grants and the likely Medicaid authority that would be used to allow a block grant, a Medicaid 1115 Demonstration Waiver. It will highlight key design issues such as which populations and funding streams can be included or excluded. It will also raise important considerations for state officials, providers, and program recipients. The two speakers will also debate the pros and cons of a block grant approach.    

Session 2


Key considerations for negotiating the budget for a Medicaid block grant

July 23, 2019, 9:30-11:00 am

To implement a block grant, Alaska will need to negotiate with the federal government to determine the amount of money that the State will receive each year. To be in a strong position to negotiate the best deal for Alaska, the State will need to understand federal requirements for 1115 Demonstration waivers and the process by which the federal government will review proposed budget amounts. Alaska will also likely need to develop its own model for estimating what these costs will be. This model will need to have data that will shape important assumptions, such as beneficiary populations, healthcare cost inflation, and increases in service use. This session will provide high-level background on these issues and answer questions from stakeholders.

REGISTER FOR SESSION 2

Session 3


Key considerations for negotiating the terms and conditions of the block grant

August 20, 2019, 9:30-11:00 am

This session will provide an overview of Medicaid block grants and the likely Medicaid authority that would be used to allow a block grant, a Medicaid 1115 Demonstration Waiver. It will highlight key design issues such as which populations and funding streams can be included or excluded. It will also raise important considerations for state officials, providers, and program recipients. The two speakers will also debate the pros and cons of a block grant approach.    

REGISTER FOR SESSION 3

Speaker Information

Dennis G. Smith


Dennis G. Smith is currently the Senior Advisor for Medicaid and Health Care Reform at the Arkansas Department of Human Services (DHS) and a Visiting Professor at the University of Arkansas Medical Sciences (UAMS) College of Public Health.

For most of his career, Dennis has been in public service, serving in Arkansas, Wisconsin, Virginia, and California. At the federal level, he has worked in both the Executive and Legislative branches, including 10 years on Capitol Hill and more than 10 years at the US Department of Health and Human Services. Dennis headed the Medicaid agency for nearly seven years, the longest tenure of any Medicaid director at the federal level. In his capacity as head of Medicaid, he negotiated Section 1115 Demonstration Projects with more than half of the states.

In Congress, Dennis worked for both the US Senate and the US House of Representatives between 1989 and 1998. As a staff member of the US Senate Committee on Finance, he was involved in landmark legislation including welfare reform, the creation of the state Children’s Health Insurance Program (CHIP) and the Adoption and Safe Families Act.

Dennis has testified at numerous congressional and state legislative committees. He has appeared on a variety of TV and radio programs and been interviewed extensively in the print media as well.

Andy Schneider


Andy Schneider is a Research Professor of the Practice at the Georgetown University McCourt School of Public Policy. Schneider has over 40 years of experience with the Medicaid program as a Congressional staffer, Executive Branch employee, private consultant, and public interest attorney. Most recently, he served under the Obama Administration as a Senior Advisor at the Centers for Medicare & Medicaid Services (CMS), where he focused on program integrity issues in Medicaid. He joined the Center for Children and Families in March of 2017. Andy has written extensively on Medicaid issues and led the development of the Medicaid Resource Book (2002) for the Kaiser Commission on Medicaid and the Uninsured. He is a graduate of Princeton University and the University of Pennsylvania Law School.