Democrats did not include any provision or opt-out clause that would let states leave new Medicaid in the future or revert to Medicaid in its old form.
In the case of new Medicaid, the states can now freely take the contract as originally offered: accede to the new program, the free money and the lack of an opt-out clause.
Kaplinsky urges his clients to include other features including an opt-out provision that allows consumers to simply avoid the arbitration clause altogether.