Matt Salo, executive director of the National Association of Medicaid Directors

There may be nobody more imbued in the policy of Medicaid than Matt Salo.

Yet, in all the scenarios tossed about regarding the U.S. Supreme Court decision on the Affordable Care Act, no one, including Salo, predicted that the court would say Medicaid expansion was up to the states.

“You show me one person who would have expected this outcome,” the head of the National Association of Medicaid Directors says. “Over the past three years, we debated the bill and the legal challenges, and no on really talked about Medicaid. It was all individual mandate this and death panel that. But since Day One, we knew it was the most important part of the bill.”

Long-term care insiders know Salo as one of the most important figures when it comes to their biggest funding stream.

He spent 12 years at the National Governor’s Association before becoming the executive director at the National Association of Medicaid Directors when it separated from an umbrella group to become a stand-alone nonprofit in 2011. 

The 41-year-old has worked on Medicaid for the past 20 years — after majoring in religious studies at the University of Virginia and spending a year substitute teaching in Northern Virginia.

While studying different religions may seem off-kilter for a healthcare policy wonk, Salo points out that it’s more similar than it might first appear. 

“The benefit was in recognizing that people can have very, very different core belief structures. If you can understand that, you can understand how the world works,” he says. “When you deal with politics, it’s no different than looking at comparative religions in that people bring to it different fundamental beliefs.” 

“Matt cut his teeth with Medicaid programs on the long-term care side,” recalls Lee Partridge, who hired Salo as an analyst at the National Association of State Medicaid Directors in 1994. 

The son of an Environmental Protection Agency lawyer and a retired English teacher, Salo has never strayed far from his Northern Virginia roots. He now lives in Alexandria, VA, with his toddler son, Kai, and wife, Jeannie. Known as a passionate basketball player, when he’s with his family the trio enjoys D.C. sights, such as the National Zoo.

The Salos have a “great sense of adventure,” notes Jennifer B. Young, partner and cofounder of Tarplin Downs & Young — and Salo’s predecessor at the NGA. Salo is not only “brilliant and committed” but is able to present complex ideas in a way people understand, even injecting humor where it’s not expected, Young says.

“Matt can make audiences laugh and inject a degree of personality that’s refreshing,” she adds.

“I’m most proud of my son,” Salo says. “But I think, professionally, it’s what I’m doing now. We are taking a group of folks, these Medicaid directors, and helping take them out of the wasteland. We want to help drive the vision of an optimally functioning Medicaid program and to give them a voice and the visibility and the tools that they so desperately need.” 

It’s a mission that nursing home operators virtually everywhere hope goes well.