Medicaid Expansion: Funding Disputes Emerge Amid Federal Proposals

Washington, D.C. — The Affordable Care Act‘s Medicaid expansion has changed coverage for nearly all adults with incomes up to 138% of the Federal Poverty Level. This includes $21,597 for individuals. To date, 41 states plus the District of Columbia have adopted this expansion, while 10 states have opted out, according to data from KFF.

At least 36 states and territories have submitted proposals to the federal government on how to utilize billions provided for broadband funding. The National Telecommunications and Information Administration (NTIA) claimed these proposals could save American taxpayers an estimated $13 billion. Critics, however, argue that these savings may not be as accurate as stated.

NTIA’s announcement on September 5 followed a deadline for states to file their proposals. The agency suggested that funds from the Infrastructure Investment and Jobs Act are still under state control, even if not spent on direct broadband deployment. Drew Garner, a director at the Benton Institute for Broadband and Society, pointed out that these funds won’t be refunded to the federal government without changes to the law.

Garner explained, “By law, all of this money is the state’s money. If a state does not spend it during their deployment grant rounds, that money still belongs to the state.” He noted that leftover funds can still support essential services like telehealth and digital literacy.

The Commerce Department‘s previous guidance did not spell out how states can use these leftover funds for non-deployment activities. Instead, it revoked previous approvals, causing confusion among lawmakers. Recently, a group of 10 Democrats requested clarification on the allowable uses of non-deployment funds.

On the other side, Louisiana Governor Jeff Landry expressed to NTIA that states should keep leftover funds for advancing education, workforce, and economic development priorities. In a letter dated Monday, Landry requested guidance for states to submit plans that align with these goals.

Garner remarked that NTIA has the authority to redistribute unused funds but specified these funds are not meant for the federal Treasury. As more states submit their proposals, the total unused funds could reach billions, triggering possible political tensions over their future use.

<p“He's not suggesting anything new,” Garner said about Landry's position. “It’s a different interpretation of existing law.” He cautioned that the administration might face pushback from both Congress and states if it attempts to claim leftover funds as federal savings.