Questions about 'partial' Medicaid expansion remain unanswered, Medicaid directors leader says

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Despite assurances offered by federal officials, state Medicaid directors remain dissatisfied with the lack of guidance provided to states about the Affordable Care Act's Medicaid expansion.

Matt Salo, executive director of the National Association of Medicaid Directors, wants to know if states can implement “partial expansions” of Medicaid and stay in compliance with the law, according to the Bureau of National Affairs.

The law requires states to extend Medicaid eligibility to adults under 65 with incomes of 133% of the federal poverty level. But Salo, whose organization sent the Centers for Medicare & Medicaid Services a list of questions in July, says it's still up in the air whether states have the flexibility to extend eligibility to adults with incomes of just 100% of the poverty level.

“If a state could partially implement the Medicaid expansion to 100 percent of the poverty level, then the exchange could provide subsidies above that,” Salo told BNA. “That might be a more politically palatable solution for some states.”

Cindy Mann, director of the Center for Medicaid and Children's Health Insurance Program Services at CMS, told attendees of last week's National Conference of State Legislatures that regulators will give states flexibility with the expansion and promised that more guidance would follow in coming months.

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