HHS rejects flexibility on Medicaid expansion

Citing financial burdens, states are asking for flexibility on expanding their Medicaid programs as part of the Patient Protection and Affordable Care Act--a position that the Obama Administration has rejected, reported The Washington Post.

Virtually all of the requests for flexibility are coming from conservative states such as Louisiana and Arizona, whose Republican governors are opposed to the ACA, according another Post article.

A recent letter from 11 GOP governors to President Obama noted that "to make any healthcare reform truly successful, [the administration] should let states do what they do best--innovate and tailor solutions to the needs of their citizens," the governors wrote.

In part, the governors want exemptions from the requirement that Medicaid eligibility be raised to 138 percent of the Federal Poverty Level.

On Tuesday, U.S. Department of Health & Human Services Secretary Kathleen Sebelius made it clear to the governors that states could not expand Medicaid only partially. "The law does not provide for a phased-in or partial expansion," HHS said in guidance accompanying Sebelius' letter, according to the Los Angeles Times.

The Obama Administration's position has been applauded by the public hospital sector. "We are greatly encouraged by the Centers for Medicare & Medicaid Services' decision ... to pursue an expansion of Medicaid consistent with the scope of the Affordable Care Act,"  Bruce Siegel, M.D., CEO of the National Association of Public Hospitals and Health Systems, said yesterday in a statement.

"The agency's guidance follows the letter and spirit of the law and takes an important step toward significantly reducing the ranks of the uninsured," he added.

For more:
- read the Post article on the governors's request
- here's the Post article on the HHS reply
- read the Los Angeles Times article
- here's the NAPH statement (.pdf)