Medicaid State Options Under PPACA Clarified at NCSL Health Meeting

NCSL's Task Force on Federal Health Reform Implementation featured Cindy Mann, Director of the Center for Medicaid and CHIP Services at CMS/Department of Health and Human Services, along with six additional presenters.  At the August 6, 2012 session in Chicago, she announced a new clarification about states' voluntary choices as to when, if and for how long states can expand their Medicaid coverage for low income adults.

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The clarified policy means that, for example, a state can elect to expand Medicaid to the new standard  of 138% of federal poverty guildeines for adults without children, for 2014, 2015 and 2016, and receive 100% federal reimbursement; the state also can decide to change or reduce that expanded coverage in 2017 or later, with no penalty or financial consequences from HHS. The following is an interview accompanied by a video highlight by Director Cindy Mann, as conducted with Richard Cauchi, Program Director at NCSL.   NCSL:  “This morning you spoke with more than 300 legislators, state legislative staff and other key policymakers interested in health reform and health policy.   What was your key message to that group? Cindy Mann: “Well, there was a lot of interest, of course, in the Supreme Court decision and how it affects the decisions at the state level with respect to the Medicaid program.  The key message to states is there is a lot to think through and there is no deadline by which states have to make that determination.  We expect and encourage states to look at what their choices are, and what their options are, and that in that regard we made it clear that the program, the expansion of low income adults, is voluntary with states; that means a state can decide when to come in, if to come in  and also, if a state does adopt the expansion, and determines at a later time, for whatever reason, that it does not want to maintain the expansion, it can also decide, since it is a voluntary program,  to drop the expansion.  We talked about the fact that all other aspects of the program remain intact, including the very favorable federal match rate that is available, and that states need to think through the costs and the benefits of moving forward.”

NCSL:  “Thank you, that is very helpful.”

Cindy Mann - PowerPoint Presentation  [PDF format].     To view PDF files, use or install Adobe Acrobat Reader. 

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