Answering the question on the minds of many state policymakers, the Obama administration said Monday it will not provide full federal funding for states that go only part of the way on expanding Medicaid.
Health and Human Services Secretary Kathleen Sebelius announced the decision in a letter sent to governors. Several states had floated the idea of allowing a partial expansion. The Affordable Care Act says states should expand Medicaid in 2014 to cover anyone earning 138% or less of the federal poverty level. That’s around $32,000 for a family of four.
The decision means, for example, that a state can’t decide to fund expansions for just up to 90% of the federal poverty level.
While upholding the ACA, the Supreme Court said states could not be required to expand Medicaid. At least a handful of states, including GOP-led Texas and Florida, have said they would not expand their Medicaid programs, while 17 states have said the would in fact expand theirs. HHS noted that it would consider waivers for states in 2017, when federal funding begins to scale back.