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ACA Ruling Leaves Ambiguity About Medicaid MOE Provision

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ACA Ruling Leaves Ambiguity About Medicaid MOE Provision

July 5, 2012

While the dust is still settling from the Supreme Court’s ruling on June 28 upholding the Affordable Care Act (ACA), one provision has been greatly overlooked in much of the commentary discussing the future implementation of the law: the fate of the ACA’s Maintenance of Effort (MOE) provision.

The MOE provision requires states to maintain their current Medicaid and Children's Health Insurance Program eligibility standards until 2014 when Medicaid expansion and other provisions take effect. Some people have speculated that because the Medicaid expansion has been ruled as an optional program for states, after 2014, states could scale back current eligibility standards for Medicaid and CHIP, resulting in fewer persons covered.

The Center for Budget and Policy Priorities wrote a paper last year that outlined the consequences should states no longer follow the MOE provision. The court's ruling did not address the MOE provision specifically, and other commentators do not believe the opinion can be read in a way that threatens it, though it may take future litigation to clarify its status.