Implementation: Advocates' To Do List
Option to Expand Medicaid Before 2014
(Section 2001(a)(4), as amended by Section 10201(b), of the Patient Protection and Affordable Care Act; Amends Section 1902 of the Social Security Act)
All states are required to expand Medicaid eligibility to 133 percent of poverty beginning in 2014, and will receive full federal financing for all newly eligible individuals in 2014-2016. However, starting April 1, 2010, states can expand Medicaid to adults with income up to 133 percent of poverty through a state plan amendment (a waiver is not necessary) and receive their normal federal matching rate for this coverage. The state will still receive the increased federal support for these populations beginning in 2014. Since most states are already facing severe budget crises and cannot afford to expand Medicaid now, this option will be most attractive to the states that already offer state-funded coverage to adults with income below 133 percent of poverty. These states can save money by taking up the new option and drawing down federal dollars for coverage they are already providing.
- If your state offers state-funded coverage to any adults with income below 133 percent of poverty, explore what it would take to bring that coverage to Medicaid standards.
- Talk to your state Medicaid agency and any likely supporters in your state legislature to determine whether this idea holds promise in your state.
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