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CMS Says No Extra Funding for States That Do Not Make Full Medicaid Expansion and Offers Other ACA Guidance


On December 10, 2012 the Center for Consumer Information and Insurance Oversight (CCIIO), a component of the Centers for Medicare and Medicaid Services (CMS), published a "Frequently Asked Questions on Exchanges, Market Reforms and Medicaid." Among the more notable guidance in the FAQ, CCIIO clarified that if states pursue a partial expansion of Medicaid coverage, rather than the full expansion to 133% of the federal poverty level, then the state will not receive federal matching funds for that partial expansion. That is, full expansion is a condition precedent to federal matching funds—there are no federal matching funds for partial expansions. The FAQ also noted that a state that participates in the Medicaid expansion may elect to drop the coverage at a later date. Additionally, the FAQ provides guidance on, inter alia, the interplay between federally-facilitated exchanges and states, multistate plans, consumer outreach and eligibility, the Medicaid expansion, and coordination between the exchanges and other programs. Click here for the full FAQ.

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A. Xavier Baker
Partner – Washington, D.C.
Phone: +1 202.624.2842