July 30, 2014

Here Today, Gone Tomorrow

Under the Affordable Care Act (ACA), states are required to expand their Medicaid programs to 133% of the FPL in 2014 or risk losing their federal funding. However, on June 28, the Supreme Court ruled this to be too coercive to the states and made the expansion of Medicaid optional. Although the federal government promises to pay for the majority of the costs of the expansion, many states have complained that expanding eligibility will be too expensive for them to implement.

During the National Conference of State Legislatures summit on August 6, Cindy Mann, deputy director for the Centers for Medicare & Medicaid Services (CMS), announced that states have the option to expand Medicaid now and drop the additional coverage later. This is one of the few public comments from CMS addressing the Medicaid expansion since the Supreme Court decision. Mann’s comments come after the National Association of Medicaid Directions sent a list of questions to CMS to understand what the Supreme Court ruling means for states. The US Government Accountability Office also released a report in August 2012 that requested clarification from CMS on the ruling.

While this option gives states more flexibility on whether to implement the expansion, questions remain about what this means for the coverage of this newly eligible population. Will they have coverage one day and no longer be covered under Medicaid the next? Will states look at what is in the best interest of the underserved or worry more about their budgets? Stay tuned to find out what states are deciding to do on this issue.

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