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Fact Sheet
January 2019

State Plan Amendment Approval Time Frames

There are various ways that states can change their Medicaid program. A change that complies with Medicaid law, such as a straight Medicaid expansion like those approved in recent ballot initiatives in Idaho, Nebraska, and Utah, can be made through a state plan amendment (SPA).

This analysis summarizes the SPA approval process and identifies where delays in the process might occur.

It is part of the Medicaid Expansion Leadership Team's Medicaid Expansion Toolkit.