On the con side, Medicaid expansion would be funded completely by the federal government only through 2016. In 2017, federal funding for new Medicaid members would fall to 95%, phasing down to 90% in 2020 and beyond. Opponents note that states — already under pressure from a weak economy — would be required to step up spending as the feds step back.Finally, expanding Medicaid is not a one-time decision for states. In theory, states could expand and receive the extra federal funding until 2016, and then contract if this funding changes. Service roll-backs may prove difficult. For more information on how the Supreme Court’s decision on the Affordable Care Act affects states, contact firstname.lastname@example.org. About HMS HMS is the nation's leader in coordination of benefits and program integrity services for healthcare payers. HMS's clients include health and human services programs in more than 40 states; commercial programs, including commercial plans, employers, and over 120 Medicaid managed care plans; the Centers for Medicare and Medicaid Services (CMS); and Veterans Administration facilities. As a result of the company's services, clients recovered over $2 billion in 2011, and saved nearly $7 billion through the prevention of erroneous payments.