The National Governor’s Association begins its annual meeting in Virginia today with the group asking federal authorities for clarification on expanding Medicaid in their states.

In a letter to Health and Human Services Secretary Kathleen Sebelius, the NGA asks whether opting out of the expansion would mean that other Medicaid provisions in the Affordable Care Act would still apply. The governors also want to know whether states could phase in Medicaid coverage up to 133% of the federal poverty limit after 2014 and still receive federal funds. Another question is whether states that don’t go up to 133% of the federal poverty limit could still receive federal funds for the “newly covered.”

Medicaid funding issues are critical to long-term care operators since the federal-state program pays for about two-thirds of all nursing home care.

The National Association of Medicaid Directors also sent a letter to HHS, asking abut whether states are still subject to maintenance-of-effort requirements related to eligibility, and how CMS is defining “newly eligible” people in states that have already expanded Medicaid to adults prior to the ACA implementation.

While some Republican governors have said their states would not partake in Medicaid expansion, others, such as Georgia Gov. Nathan Deal, are facing pressure in their states to allow more people onto the Medicaid rolls. Deal has said he will wait until after November’s elections to make a decision, Georgia Health News reported.