States will not have to repay federal funds they received for either Medicaid-related IT upgrades or to implement a state-run health insurance exchange, even if they ultimately do not undertake those initiatives, according to the head of the CMS.
Marilyn Tavenner, acting administrator of CMS, wrote Virginia Gov. Robert McDonnell (R), who is also chairman of the Republican Governors Association, on Friday to answer a couple of outstanding points state leaders have raised in the wake of June 28 U.S. Supreme Court decision generally upholding the constitutionality of the 2010 healthcare overhaul. That decision also struck down the law's removal of all federal Medicaid support for states that do not expand their Medicaid programs by 2014. The law required Medicaid eligibility for all people with incomes up to 133% of the federal poverty level with a 5% leeway up to 138%.