While the administration has been flexible about numerous aspects of Medicaid expansion called for in the healthcare reform law, there is at least one thing that is not negotiable: States will not get full federal funding from states that go only part way on expanding their Medicaid programs.
It had been a question on many state execs’ and providers’ minds until Health and Human Services Secretary Kathleen Sebelius made the declaration in a letter to governors in mid-December.
Several states had floated the idea of allowing a partial expansion. The Affordable Care Act says states should expand Medicaid in 2014 to cover anyone earning 138% or less of the federal poverty level. That’s around $32,000 for a family of four.
The decision means, for example, that a state can’t decide to fund expansions for just up to 90% of the federal poverty level.
HHS noted that it would consider waivers for states in 2017, when federal funding begins to scale back.