With less than a dozen days left in power, the Trump administration on Friday approved a radically different Medicaid financing system in Tennessee. With this move, the federal government is for the first time granting a state broader authority in the operation of its health insurance program for the poor without interference from Washington, allowing Tennessee to make decisions on such issues as whether to add new benefits or eligibility categories or spend Medicaid dollars outside of health care, if it thinks that would help enrollees. Instead of the open-ended federal contribution to the funding of Medicaid in all other states — which increases with higher enrollment and associated health costs — Tennessee will instead get a capped amount of money, via an annual block grant. The annual funding cap will increase if enrollment grows. What's different is that, unlike with other states, Medicaid funding to Tennessee won't automatically keep up with rising expenses. The approval is a 10