Feds Approve Minnesota’s “Early Expansion” of Medicaid
Minnesota belongs to a small group of states that have health insurance programs for low-income adults that are funded by state money (no federal match). These programs are increasingly at risk given the budget gaps that states are facing.
Funding for Minnesota’s General Assistance Medical Care program, which provides coverage for low-income childless adults who are not eligible for Medicaid, is in jeopardy. Instead of cutting the program, Gov. Dayton asked for and received approval from CMS to enroll about 95,000 people who are currently either in state health care programs or who have no health insurance into the Medicaid program where the state can draw down a federal match to help with funding.
The ACA allows states to expand Medicaid to people with incomes up to 133 percent of poverty “early”, beginning on April 1, 2010, through the state plan amendment process. This option allows states to draw down federal funds for coverage that was previously paid for with state-only money. Early expansion is available to all states, although with the budget shortfalls that many states are facing, it may only be attractive to the small number of states that are already providing coverage for this population through state-funded programs. Expanding Medicaid early does not affect a state’s ability to receive the higher matching rate for newly eligible populations beginning in 2014.
To date, Connecticut, Washington and the District of Columbia have also received approval and are enrolling people in early expansion programs. However, not every state with state funded programs are opting for the Medicaid expansion.
States Return Federal Grants After Florida Judge Ruling
On Feb. 17, the U.S. Department of Justice motioned for Judge Vinson to clarify his order declaring the Affordable Care Act’s individual mandate unconstitutional. The Department of Justice specifically requested clarification on whether government agencies and employees were “relieve[d]...of their rights and obligations under the Affordable Care Act.”
In response to the ruling, a few states have returned, or are discussing returning, some of the federal funding made available through provisions in the law or have chosen not to apply. As of February 23, a total of $3,219,508,190 in federal awards has been distributed to all 50 states through the ACA.
The following are examples of states returning or not applying for federal grants:
• Alaska Governor Sean Parnell elected not to apply for federal funds to establish a health insurance exchange.
• Florida Governor Rick Scott returned $1 million that was awarded to the state to begin implementation planning for health insurance exchanges and another $1 million that would have funded a system to monitor premiums and insurance-rate changes.
• New Hampshire’s House Republican leaders asked the Executive Council to block a $610,000 federal planning contract that would use federal grant funds to create a state health insurance exchange shortly after the Legislative Fiscal Committee voted 9-1 to accept it.
• Wisconsin Governor Scott Walker returned a $637,114 federal “consumer assistance” grant.
Each of these states has accepted and not returned other ACA-related federal grants. For example, Wisconsin was recently awarded an HHS “Early Innovator” grant for $37,757,266, to help design and implement the information technology infrastructure needed to operate health insurance exchanges.