Administration: No enhanced match for partial Medicaid expansion

The Obama administration filled in a key detail of what states must do to receive full federal funding for an expansion of Medicaid under the 2010 health law. Health and Human Services Secretary Kathleen Sebelius said in a letter sent Monday to governors that states cannot partially expand their Medicaid programs and get full federal funding. In a blog post, Sebelius also outlined other points of the guidance being provided to states, and gave a conditional nod to exchange plans submitted by Colorado, Connecticut, Massachusetts, Maryland, Oregon and Washington.

Kaiser Health News: The Obama administration answered a key question from governors on Monday with a clear no: States may not expand Medicaid only part of the way and still get the full federal funding provided in the Affordable Care Act. The decision, announced by Health and Human Services Secretary Kathleen Sebelius in a letter sent Monday to governors, is significant because after the Supreme Court decision in June made the Medicaid expansion optional, several states have floated the idea of a less generous expansion than called for in the federal health law (Galewitz, 12/10). 

The Hill: States Can't Do Partial Medicaid Expansion, HHS Says
The Health and Human Services Department said the law does not allow for a partial expansion -; at least not with the level of federal funding available to states that participate in the expansion. ... Some states had asked whether they could expand Medicaid only partially -; not all the way to 133 percent of poverty -; and still get the full federal payment. HHS said Monday that it simply doesn't have that authority (Baker, 12/10).

The Associated Press/Businessweek: The administration's ruling puts the ball back in the states' court, with officials saying states can expand Medicaid part way, but they wouldn't get the three years of 100 percent federal funding provided under the law (12/10).

Politico Pro: HHS Won't Allow Partial Medicaid Expansion In States
States leaning on the Obama administration to permit partial Medicaid expansion under the health law got a succinct answer Monday: No way. There will be no federal matching funds for partial Medicaid expansion, CMS Acting Administrator Marilyn Tavenner said during a conference call Monday with reporters (Cheney, 12/10).

The Washington Post's Wonk Blog: White House To States: On Medicaid Expansion, It's All Or Nothing
The administration's reasoning goes like this: The federal government was giving states a really, really good deal on the Medicaid expansion. It was footing the entire bill for the newly eligible enrollees for three years. To put that in context, the feds usually chip in about half or two-thirds of a state's Medicaid costs (Kliff, 12/10).