State Update

May 2013 Update on State Medicaid Expansion under the Affordable Care Act

(Local Policy, State Policy, Medicare and Medicaid, ACA) Permanent link   All Posts

Twenty states and the District of Columbia plan to expand their Medicaid program under the Affordable Care Act (ACA), according to a recent report by Avalere. Under the ACA, as of January 1, 2014, Medicaid eligibility will be expanded to reach all children and adults under age 65 with incomes at or below 133% of the federal poverty level. On June 28, 2012, the U.S. Supreme Court upheld the ACA; however, the Court’s ruling allows the ACA’s Medicaid expansion to proceed, but without a provision threatening non-compliant states with the loss of their existing Medicaid funding. As a result, states can either opt-in or opt-out of the Medicaid expansion provision.

According to information released by the U.S. Department of Health and Human Services, there will be no deadline for states to decide whether to participate in the Medicaid expansion; however, the longer states take to opt-in, the less that state will receive in federal matching funds. Specifically, the ACA provides 100% federal matching funding for covering newly eligible Medicaid recipients in states that choose to expand for 2014, 2015, and 2016. For later years, the federal match decreases until it reaches 90% for 2020 and subsequent years.

To learn which states plan to expand their Medicaid program under the ACA and which states plan to opt-out, click on the U.S. map. Please be aware that some states are still considering legislation related to Medicaid expansion and, as a result, the map may change. On May 2, West Virginia Governor Earl Ray Tomblin (D-WV) announced that the state would expand Medicaid and cover more than 91,000 additional West Virginians. Additionally, on May 9 Governor Steve Beshear (D-KY) announced that the state would expand Medicaid to cover 308,000 more individuals. The governor stated that the expansion of Medicaid in Kentucky would create nearly 17,000 new jobs and have a $15.6 billion positive economic impact on the state between its beginning in fiscal year 2014 and full implementation in fiscal year 2021. To learn more about the governor’s decision to expand Medicaid click here. According to staff from both governor’s offices, no enabling legislation is required to expand Medicaid in their states.