As we noted yesterday, Secretary Sebelius sent a letter to the nation’s Governors on Wednesday clarifying that the Supreme Court ruling affects only HHS’s ability to enforce the Medicaid expansion for adults to 133% of the FPL, not other provisions such as the maintenance-of-effort requirement. Now, the Acting CMS Director Marilynn Tavenner, has followed up with a letter to the Republican Governors Association providing some additional, notable clarifications:
— No rush.
Tavenner said that states will not face a deadline for alerting HHS as to whether they will implement the Medicaid expansion for adults. I’m hoping that the flexible timeframe makes it possible for states to take a deep breath and get past the heated political rhetoric of the pre-election season before making a hard and fast decision about the Medicaid expansion.
— Even if you are holding back, we won’t.
In an admirable display of restraint, Tavenner said that HHS will continue to make 90/10 matching funds available to states to upgrade their Medicaid eligibility and enrollment systems even if they have not yet committed to the Medicaid expansion. And, there will be no obligation to re-pay the funds even if they never adopt it. The decision is a notable display of HHS’s willingness to focus on what will be useful to the nation’s low-income people. They could have adopted a punitive approach and yanked back the funds from states that are balking at the Medicaid expansion, but elected not to do so. This is good news for the nation’s low-income children and families who often must navigate decades-old eligibility systems to secure coverage.