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State fiscal incentives for Medicaid expansion continue after the end of public health emergency
State fiscal incentives for Medicaid expansion continue after the end of public health emergency
Eleven states are still refusing the federal Medicaid expansion under the Affordable Care Act. While health care coverage options remain more limited in these states than in the 39 states and the District of Columbia that have adopted expansion, federal relief funding during the COVID-19 pandemic has allowed some residents to remain enrolled in Medicaid since January 2020 who will fall into a coverage gap - primarily parents with rising incomes. Under the Families First Coronavirus Response Act, the federal government provided extra federal funding to states coupled with the requirement that residents enrolled in Medicaid not lose their coverage throughout the public health emergency. This policy was applied to all states regardless of Medicaid expansion status. However, the recently enacted Consolidated Appropriations Act ended the continuous coverage requirement, effective after March 31, 2023, although states will continue to receive phased-down federal matching rate increases through the end of the calendar year. As COVID-19 related federal funding winds down in many areas it is important to distinguish which federal funding remains available including generous incentives enacted in 2021 for states that have not yet expanded Medicaid to parents and other adults below 138 percent of the federal poverty line.
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