HHS: States need waiver to privatize Medicaid expansion

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HHS released a questions-and-answers document Friday explaining more about its approach to private expansions. The document says states will need a waiver in order to proceed — despite Beebe's confidence that his state would not need a waiver.

"HHS will consider approving a limited number of premium assistance demonstrations since their results would inform policy for the State Innovation Waivers that start in 2017," the department said. "As with all such demonstrations, HHS will evaluate each proposal that is submitted and consider it on a case by case basis relative to this standard."

In order to win HHS's approval, a state must guarantee a choice between at least two qualified health plans and be "closely aligned with the benefits available" in newly created insurance exchanges, where the expansion population would access coverage under a privatized model.