Arkansas: Medicaid Expansion Only Item on Special Session Agenda

Governor Asa Hutchinson (R) announced that his Medicaid expansion renewal plan, called "Arkansas Works," will be the only agenda item for the special legislative session set to begin April 6. The Governor removed his Medicaid managed care plan from the agenda at the request of legislative leadership. Governor Hutchinson's managed care planproposed transitioning certain high-risk populations and services from the State's traditional Medicaid program to full-risk managed care. Additionally, the Governor said he would use the savings and increased revenue from his managed care plan to decrease the wait list for a Medicaid waiver program that provides services to individuals with developmental disabilities. Legislators had developed an alternative managed fee-for-service bill that was not on the special session agenda.

Indiana: CMS to Assess Impact of Alternative Medicaid Expansion on Access to Care

CMS received expedited approval from the Office of Management and Budget to evaluate the impact of Indiana's alternative Medicaid expansion on beneficiaries' access to care, according to Modern Healthcare. Three beneficiary surveys will focus on the program's transportation benefit waiver, the application process, and the requirement that individuals with incomes from 100% to 138% of FPL contribute monthly to a health savings account or lose coverage. CMS requested this emergency approval so that the impact of the State's expansion program could "adequately inform" CMS's decision making regarding Indiana's and other states' 1115 waivers, in particular the upcoming renewal process for Indiana's non-emergency medical transportation waiver, due December 1, 2016. After approving the State's waiver in 2015, which expanded Medicaid through a health savings account-like model, CMS contracted with a vendor to oversee the State's self-evaluation as well as two other contractors to conduct a separate evaluation. Governor Mike Pence (R) has expressed concerns that two independent evaluations may produce conflicting results and about the objectivity and potential conflicts of interest among the federal vendors.

Nebraska: Senate Rejects Medicaid Expansion for Fourth Consecutive Year

The Legislature voted 28-20 to remove LB 1032 from this year's legislative agenda, effectively rejecting the Medicaid expansion bill which would have provided healthcare coverage to an additional 77,000 residents. The bill proposed a three-year pilot program that would enrollthe majority of expansion adults into qualified health plans on the Marketplace, excluding the medically frail and those with cost-effective employer sponsored insurance. Governor Pete Ricketts (R) and other opponents of the bill, including State Medicaid Director Calder Lynch,raised concerns about the bill's long-term costs, while supporters promised to continue their Medicaid expansion efforts next year.

New Hampshire: Senate Reauthorizes Medicaid Expansion

The Senate voted 16-8 to approve the House's bill to renew the Medicaid expansion program through 2018. The bill now goes to Governor Maggie Hassan (D) who has pledged to sign the legislation into law. The bill includes several new requirements for the Medicaid expansion program, including that enrollees be employed or engaged in a job search. However, the bill also includes a severability provision that would permit renewal of the program even if CMS does not approve some of the new requirements, including the work provision.