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Panel on the American Rescue Plan Act: State’s Early Experiences with Implementation

The American Rescue Plan Act of 2021 (ARPA, P.L. 117-2) provided a temporary increase in the federal medical assistance percentage (FMAP) for state Medicaid programs to support the infrastructure for home- and community-based services (HCBS). It increased the FMAP by 10 percent for the one-year period from April 1, 2021 through March 31, 2022. States had to submit spending plans to the Centers for Medicare & Medicaid Services (CMS) for approval on how they would spend this new money.

All 50 states and the District of Columbia have received full approval from CMS and have begun implementation of the initiatives included in their spending plans. States are required to submit quarterly spending reports and semi-annual narratives to CMS on their progress. States have until March 31, 2025 to spend the increased FMAP earned during the one-year funding period.

This panel provided an overview of state spending plans and initial implementation efforts. The panel also discussed sustainability of initiatives and the federal policy levers that might enable states to use ARPA funds to improve state HCBS systems and beneficiary access.

Panelists included:

  • Elizabeth Matney, state Medicaiddirector, Iowa Department of Health and Human Services;
  • Kevin Bagley, director, Medicaid & long-term care, Nebraska Department of Health and Human Services;
  • Heidi Hamilton, acting director of the disability servicesdivision, Minnesota Department of Human Services; and
  • Camille Infussi Dobson, deputy executive director,ADvancing States.