The Trump administration has formally denied Utah's request to partially expand Medicaid funding while still receiving a full federal match, and Friday also announced it would reject the state's plan to cap enrollment in the program.
The Centers for Medicare & Medicaid Services (CMS) revealed last month that it would not agree to pay out the full federal allotment allowed under the Affordable Care Act if the state went forward for a "partial expansion." CMS said at the time that while it supports state flexibility in Medicaid, it would reject plans that do not fully expand Medicaid while seeking full government funding.
In a letter sent to the state Friday, CMS also said it would reject full payments under an enrollment cap in Utah for similar reasons.
"A number of states have asked CMS for permission to cover only a portion of the adult expansion group and still access the enhanced federal funding available through Obamacare," a CMS spokesperson told FierceHealthcare. "Unfortunately, this would invite continued reliance on a broken and unsustainable Obamacare system."
"While we have carefully considered these requests, CMS will continue to only approve demonstrations that comply with the current policy," the spokesperson said.
Utah rolled out the partial expansion plan following voter approval of a ballot measure for Medicaid expansion. CMS did approve a "bridge" version of the partial expansion earlier this year, which allowed the state to begin enrollment in expanded Medicaid in April.
CMS has not yet weighed in on Utah's request for a per capita funding cap in Medicaid. Under such a model, the state would be paid a set level of funding for each Medicaid enrollee.