AJAC Features Matt Salo on Medicaid After the Midterms

AJAC Features Matt Salo on Medicaid After the Midterms

FOR IMMEDIATE RELEASEDecember 30, 2014

Will Medicaid expansion continue in the face of Republican gains in both houses of Congress and in statehouses nationwide, even in places like Massachusetts and Maryland? If so, what will expansion look like? And what of the “super waivers” permitted by the Affordable Care Act (ACA) in 2017, after President Obama leaves office?

How states put their individual stamps on Medicaid and the ACA is the business of Matt Salo, the executive director of the National Association of Medicaid Directors, who writes in this month’s issue of The American Journal of Accountable Care on “The 2014 Elections and the Future of Medicaid.” For the full article, click here.

Mr Salo makes a number of key observations about Medicaid expansion, with perhaps the most important being that as Republican-led states craft their own plans, leaders should not assume any waiver concept will be rejected, based on approvals in Iowa, Pennsylvania, and Michigan. “In fact, the approval of the expansion in those states demonstrated an evolution of the administration's original thinking on the expansion, creating in effect, an iterative process where you don't know what can be approved until you ask,” he writes.

After Mr Salo’s article went to press, Medicaid expansion plans or possibilities were announced in Tennessee, Alabama, Florida, and Utah, including some with work requirements that were previously rejected in Pennsylvania.

Also of importance, as 2016 presidential candidates emerge, is the concept of the “super waiver,” which Mr Salo notes almost no one has mentioned. Permitted after 2017 by the ACA, these waivers would allow entire portions of the ACA to be set aside as long as the law’s broad concepts are left intact.

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