Alaska: Governor Intends to Expand Medicaid by Executive Action

Governor Bill Walker’s (I) announcement of his plans to expand Medicaid in Alaska, effective September 1, without the Legislature’s approval came after the Legislature rejected expansion twice this summer. Under Alaska State law, the Governor can accept federal funds unilaterally when the Legislature is not in session but must submit a formal notice to the Legislative Budget and Audit Committee. Governor Walker submitted his notice on July 16 and the Committee has 45 days to approve, recommend against, or take no action on the request. Alaska's Department of Health and Social Services estimates that an additional 42,000 Alaskans will be eligible for Medicaid under the expansion, and that the State will save more than $6 million in its first year.

Iowa: State to Stop Enrolling Medicaid Expansion Adults through the Marketplace

Iowa will no longer enroll Medicaid expansion adults with incomes above 100% of the federal poverty level in qualified health plans (QHPs) on the federal Marketplace starting in 2016, according to a waiver amendment draft released for public comment. As part of a larger transition to managed care, in 2016 these individuals will be enrolled in Medicaid managed care plans. Iowa’s Marketplace program became voluntary when CoOportunity Health, one of two insurers offering QHPs at the time, withdrew from the Marketplace in December 2014. The waiver also states that the other Marketplace insurer, Coventry Health Care of Iowa, will not accept additional expansion adults and will not continue to offer coverage to existing expansion enrollees after the State completes its transition to Medicaid managed care. Iowa will consider reinstating the Marketplace program if additional insurers offer coverage on the Marketplace in the future.

Maine: Medicaid Family Planning Eligibility Expansion in Veto Limbo

The future of legislation (LD 319) that expands Medicaid reproductive health benefits to individuals up to 209% of the federal poverty level in Maine is in question despite assertions by the legislature and the State Attorney General that the bill became law on July 12 because the Governor neither signed nor vetoed within 10 days of passage. Governor Paul LePage (R), however, considers his veto on July 16 to be valid and is seeking a State Supreme Court ruling on the fate of the bill and 64 others. Should the bill survive the challenge, the State Department of Health and Human Services will be required to submit a state plan amendment expanding eligibility to an estimated 12,900 individuals, effective October 1.

Utah: Leaders Announce Framework for Medicaid Expansion

In a surprising turnaround, Governor Gary Herbert (R) and Republican legislative leaders announced their consensus on a "conceptual framework" for Medicaid expansion in Utah just days after House Majority Leader Jim Dunnigan stated that the working group would delay an expansion plan decision until January 2016. Details have yet to be released, but the State will reportedly generate funding from hospitals, physicians, and pharmaceutical companies—potentially through a new tax. A full draft of the plan is anticipated in the coming weeks, as is a special legislative session for its consideration. The plan must still overcome historic opposition to pass the full legislature and would require approval from CMS.