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In 2012, the Supreme Court ruled that even though Congress can expand Medicaid, it can’t deny existing Medicaid allotments to those states that choose to not participate in that expansion – meaning that there is no punishment for non-participation in the Medicaid expansion. Under the ruling, States could lose access to the new enhanced FMAP rate if they don’t participate, but not the funding they already receive. This ruling left states with the opportunity to choose whether or not to expand Medicaid. As a result, states were left with three options related to the expansion of Medicaid: 1 . . .
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