HHS Issues Final Rule on Medicaid Expansion Funding

HHS released specifics of its increased Federal Medical Assistance Program rates for newly eligible Medicaid beneficiaries in states that expand the program under the optional provision of the health law in a final rule issued by the agency.

Through 2016, HHS will make the payments in full and taper down to a permanent 90 percent matching rate by 2020 for states that increase their Medicaid program eligibility criteria to 133 percent of the poverty line. Since the federal government disregards 5 percent of income when determining eligibility, the ceiling effectively becomes 138 percent of the federal poverty line.

The government will cover 100 percent of the cost of beneficiaries who are newly eligible for Medicaid due to states' voluntary changes to the program, but HHS included in the rule provisions to fund coverage for some adults who are not newly eligible. The rule also includes details for eligibility screening, flexibility for states in delivering Medicaid coverage, information on audits and specifics on states' authority to change parts of Medicaid without a waiver.

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