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HHS Details Limits to Medicaid Expansion

John Commins, for HealthLeaders Media, December 11, 2012

The memo went on to state that: "in 2017, when the 100% federal funding is slightly reduced, further demonstration opportunities will become available to states under State Innovation Waivers with respect to the Exchanges, and the law contemplates that such demonstrations may be coupled with section 1115 Medicaid demonstrations."

"This demonstration authority offers states significant flexibility while ensuring the same level of coverage, affordability, and comprehensive coverage at no additional costs for the federal government. We will consider section 1115 Medicaid demonstrations, with the enhanced federal matching rates, in the context of these overall system demonstrations."

For one person, 133% FPL is an annual income of $14,856. For a family of four it is $30,657.

On other issues, the memo noted that the Obama administration no longer supports the Medicaid blended matching rate that it initially proposed. By some estimates the federal government had hoped to save about $100 billion over the next decade by using the blended rates to shift costs to states.

But when the U.S. Supreme Court ruled last June that the Medicaid expansion under the PPACA was optional, the Obama administration had to sweeten the pot to attract more states.

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