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HHS releases guidance on Medicaid expansion, exchanges

December 10, 2012

States will not be eligible to receive federal matching funds unless they fully implement the Medicaid expansion to 133% of the federal poverty level, as called for under the Patient Protection and Affordable Care Act, the Department of Health and Human Services announced today. The new guidance includes answers to 39 frequently asked questions raised by governors, state legislators and others on the Medicaid expansion, health insurance exchanges, and other market reforms. HHS states that the ACA "does not provide for a phased-in or partial expansion. As such, we will not consider partial expansions for populations eligible for the 100% matching rate in 2014 through 2016." However, HHS will consider demonstration proposals from states that elect not to expand "to the extent that [the proposal] furthers the purposes of the program, subject to the regular federal matching rate." HHS also notes that it no longer supports the blended Medicaid FMAP proposed in the presidents' fiscal year 2013 budget. "The Supreme Court decision has made the higher matching rates available in the [ACA] for the new groups covered even more important to incentivize states to expand Medicaid coverage," HHS states. "The Administration is focused on implementing the [ACA] and providing assistance to states in their efforts to expand Medicaid coverage to these new groups."