Alaska: Governor Determining Path Forward after Removal of Medicaid Expansion from Budget
Governor Bill Walker (I) is determining next steps after the House Finance subcommittee removed nearly $150 million in new federal revenue for expanding Medicaid from his Fiscal Year 2016 budget proposal, as reported by Alaska Public Media. Republicans requested that the Governor submit standalone legislation, rather than make changes to the State’s operating budget, as the vehicle for implementing expansion. The Governor noted that a Medicaid expansion bill, HB18, was introduced by House Democrats in January and could serve as the standalone bill. In the meantime, Walker’s administration is meeting with House members to understand their concerns with the current expansion bill, and to discuss expansion in greater detail in order to build support.
Florida: Governor Asks President Obama Not to Cut LIP Funding
Governor Rick Scott (R) reacted to news from CMS that it would not renew funding for Florida’s Low Income Pool (LIP) program, which reimburses hospitals that treat large numbers of poor and uninsured patients, in “its present form” by sending a letter to President Obama. The Governor outlined Florida’s intent to use LIP funding to introduce quality-based payment reform and noted the State’s expectation that CMS would not leverage Florida’s option to expand Medicaid as a means to withhold LIP funding. Though Governor Scott is opposed to Medicaid expansion, the Florida Senate is currently considering “Healthy Florida Works,” a proposed expansion bill that would enable Medicaid beneficiaries to purchase private insurance in a state-run private exchange and promote “personal responsibility,” with premiums, cost-sharing and a work requirement, among other strategies.”
Kansas: Governor’s Remarks Reveal Shifting Stance on Medicaid Expansion
While attending a private event with conservative Missouri lawmakers, Kansas Governor Sam Brownback (R) remarked that if the Kansas Legislature presented him with a budget-neutral Medicaid expansion bill, he would likely sign it, according to The Missouri Times. The Governor echoed these remarks in an address to the Kansas Association of Insurance Agents, stating, "I’ve been pushing that anything we do on Medicaid expansion has to be 100-percent paid for." The Governor’s shifting stance follows a decision by House Republicans to allow for Medicaid expansion hearings, scheduled for March 18 and 19.
Montana: House Committee Republicans Deliver Blow to Medicaid Expansion
After a nearly 7-hour legislative hearing, Montana’s House and Human Services Committee members voted along party lines to move the Healthy Montana Plan—the Governor’s Medicaid expansion plan—to the House floor with a recommendation that representatives vote against the bill. According to legislative procedures, 60 representatives will need to dismiss the recommendation in order for the bill to be debated and voted on, an unlikely scenario given that the House of Representatives has a Republican majority and leadership that has expressed strong opposition to the bill in the past. Governor Steve Bullock (D) expressed continued openness to working toward Medicaid expansion after the vote, while Republican Senator Ed Buttrey will introduce a compromise bill this week, called Montana HELP (Health and Economic Livelihood Partnership), which proposes to couple Medicaid coverage with opportunities for job training and education and includes co-pays and premiums.
New Hampshire: CMS Approves Premium Assistance Waiver for Healthcare Expansion
Governor Maggie Hassan (D) announced that the federal government approved the State’s premium assistance waiver, permitting New Hampshire’s Department of Health and Human Services to enroll Medicaid expansion new adults in qualified health plans on the Federal Marketplace. The premium assistance program, approved to operate from January 1 through December 31, 2016, will exclude the medically frail and those with access to cost-effective employer-sponsored insurance. As New Hampshire expanded Medicaid through the State’s existing managed care infrastructure in mid-2014, the State plans to transition current expansion enrollees into the premium assistance program on January 1, 2016.
Utah: Medicaid Expansion Debate Continues, with Governor Noting Special Session Contingency
After Utah’s Senate passed SB164—the Governor’s “Healthy Utah” Medicaid expansion bill—the House Business and Labor Committee voted against it and then passed the “Utah Cares” bill, HB466, seen as the alternative expansion plan. Utah Cares would cover approximately 60,000 Utahns up to 100% of the federal poverty level (FPL), costing the state $64 million over two years. Healthy Utah is estimated to cover approximately twice as many people up to 138% FPL at a lower cost—$25 million for a two year pilot. Because the legislative session closes this week, Utah Cares will go straight to the Senate floor without a committee hearing. Proponents of Healthy Utah are still hoping to strike a compromise between the two plans, and Governor Gary Herbert (R) has indicated he will call a special session if a compromise cannot be reached by the close of the session.