HHS Secretary Kathleen Sebelius, shown here speaking at a conference in Washington last week. (Chip Somodevilla/Getty Images)
HHS Secretary Kathleen Sebelius, shown here speaking at a conference in Washington last week. (Chip Somodevilla/Getty Images)

The Obama Administration handed down a key rule Monday on its health care overhaul having to do with Medicaid, or Medi-Cal in California. States must expand to the federally mandated 138 percent of poverty in order to receive matching funds for those newly eligible for the program.

Because the Supreme Court ruling in June had struck down the requirement that states participate or lose existing match funds, some states thought there might be flexibility in the expansion. But the answer to that question is a clear “no” as Secretary of Health and Human Services Kathleen Sebelius explained in a letter to governors.

In a briefing last week, California’s Health and Human Services Secretary Diana Dooley indicated she was waiting for guidance from the feds about the Medicaid expansion and might not expand to the full 138 percent limit.

In an email, a spokesperson for the state’s department of health and human services said staff is currently evaluating the new information and declined to comment further at this time.

Consumer advocates said it was good to have the matter settled. “We thought that it was the case,” Anthony Wright, Executive Director of Health Access told me in a phone call, “but it’s good for the federal government to provide clarity and hopefully this allows the states to move forward with all deliberate speed.”

It’s expected that more than four million Californians will be newly eligible for Medi-Cal. Under the Affordable Care Act, the federal government will pay 100 percent of the cost of those new eligibles from 2014 to 2017. After that, the match will phase down to 90 percent by 2020.

Feds to States on Medicaid: Expand Fully or No New Funding 11 December,2012Lisa Aliferis


Lisa Aliferis

Lisa Aliferis is the founding editor of KQED’s State of Health blog. Since 2011, she’s been writing and editing stories for the site. Before taking up blogging, she toiled for many years (more than we can count) producing health stories for television, including Dateline NBC and San Francisco’s CBS affiliate, KPIX-TV. She also wrote up a handy guide to the Affordable Care Act, especially for Californians. Her work has been honored for many awards. Most recently she was a finalist for “Best Topical Reporting” from the Online News Association. You can follow her on Twitter: @laliferis

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