Yesterday, the federal government provided additional guidance to states as they consider how to expand Medicaid, as required to implement the Affordable Care Act. A full list of Questions and Answers are on the CCIIO website.
In particular, what got headlines was the clarity that in order for states to have the federal government pay for 100% of the newly eligible population, the states in turn have to expand coverage fully, including all legal residents up to 133% of the federal poverty level. (For those above 133% of the poverty level, new Exchanges may provide subsidies to afford private coverage.)
Some states had asked whether it was possible to do a partial expansion. Here in California, as the Brown Administration was doing its analysis about how to move forward, Secretary Dooley mentioned at our Health Access event last week that they were seeking a decision on this question. As we stated to KQED, the direction gives California more information on which to act.
Now that the state has more clarity, we hope we can move quickly to get ready–we have less than ten short months before we need to start signing people up for coverage, and so we need to put in place the new rules and standards as soon as possible.
Additional clarity also came regard to some more assurance about the ongoing support for Medicaid funding–the Obama Administration disavowed proposals to cut the Medicaid budget and shift costs to states, through “blended rate” proposal or otherwise. They recognize that states want more assurance that more costs of the expansion won’t get shifted in the current budget negotiations federally.