CMS official: States can opt into ACA expansion—and then opt out

Mann also clarifies that states can opt in at any time

In a statement that may ease governors' decision-making—but complicate hospitals' planning—a top CMS official said that states may decide to participate in the Affordable Care Act's (ACA) Medicaid expansion, but drop out later.

Speaking at a National Conference of State Legislatures summit in Chicago, CMS Deputy Director Cindy Mann on Monday reiterated that the Medicaid expansion "is voluntary with states" following the Supreme Court's ruling on the federal health reform law.  

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As such, Mann said that "a state can decide when to come in [or] if to come in" and join the expansion. However, if a state adopts the expansion and "determines at a later time...that it does not want to maintain the expansion, it could also decide" to drop the program, given its voluntary status.

Mann added that, "all other aspects of the law remain intact, including the very favorable federal match rate that's available."

Mann's statements represent the first public confirmation that states will have the option to opt out of the expansion, even if they first participate in it, according to Governing.

At the Chicago summit, Mann also clarified that states face no deadlines for deciding whether to participate in the expansion (AHA News, 8/7; Scott, Governing, 8/6).

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