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HHS final rule on medicaid expansion

November 4, 2013

Affordable Care Act will ensure health coverage for millions of Americans

March 16, 2012

States to receive federal funding to provide high-quality, affordable coverage

Health and Human Services Secretary Kathleen Sebelius today announced final policies that will ensure that millions of uninsured Americans will have a simple, seamless path to affordable health insurance coverage. 

“The Medicaid improvements in the Affordable Care Act will help simplify the system and ensure all Americans have the affordable high-quality coverage they need,” said Secretary Sebelius.

The Affordable Care Act makes Medicaid available to individuals between ages 19 and 64 with incomes up to 133 percent of the federal poverty level – currently $14,856 for an individual and $30,656 for a family of four. These changes will become effective in 2014 when Affordable Insurance Exchanges begin operation.  The federal government will pay 100 percent of the cost of the Medicaid expansion for the first three years and at least 90 percent after that.

“Today, too many uninsured Americans turn to the emergency room for care and can’t pay their bills,” said Marilyn Tavenner, acting administrator of the Center for Medicare & Medicaid Services (CMS). “Insuring more Americans will decrease the hidden tax states and consumers with insurance pay to cover the cost of caring for the uninsured.”

The policies announced today were first proposed in August 2011.  After the proposed rule was issued, HHS participated in listening sessions across the country to hear comments and suggestions from a diverse array of stakeholders.  In addition, CMS held a national eligibility conference attended by states and other stakeholders and conducted numerous conference calls and webinars to solicit public input.  In response, the final rule provides additional protections for consumers, as well as additional flexibilities and options for states.

The final rule announced today also makes it easier for eligible individuals and families to enroll in Medicaid and the Children’s Health Insurance Program (CHIP) by cutting back on red tape and coordinating enrollment with the new Affordable Insurance Exchanges.  Families will be able to enroll in the appropriate coverage program through a single, streamlined, online application and states will have the benefit of reduced administrative costs.

The rule builds on successful state efforts to modernize the eligibility, enrollment, and renewal processes in Medicaid and CHIP. This final rule and the recently issued Affordable Insurance Exchange final rule are building a seamless system of coverage so that in 2014, Medicaid, CHIP and the Affordable Insurance Exchanges will work together to efficiently meet consumers’ health care needs, improve quality and lower costs.

To learn more about this final rule, visit:

Note: All HHS press releases, fact sheets and other press materials are available at

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