Yesterday, the Department of Health and Human Services (HHS) released an FAQ document on state health insurance Exchanges, other market reforms, and Medicaid expansion. The document includes a section on what states should expect if they opt for a federally operated Exchange, including how states can work with the federal government to ensure the needs of a particular state are being met. HHS reiterates that there is no deadline for a state to declare to the federal government its intention to participate in Medicaid expansion to individuals at and below 133% of the federal poverty level (FPL) and that states have flexibility to start and stop the expansion. However, the federal match rates for medical
assistance to states for this expansion population are tied to specific calendar years by law (eg, 100% support for newly eligible adults in 2014, 2015, and 2016). Additionally, HHS clarified that the law does not provide for a phased-in or partial expansion to less than 133% of the FPL, something some states had been considering but were unsure if it was an allowable option.