Arkansas: Governor Says Federal Officials Committed to Revising State's Medicaid Expansion

Governor Asa Hutchinson (R) told legislators last week that federal officials were broadly supportive of his plan to amend the State's Medicaid expansion waiver and were committed to finding common ground on the proposed changes. The Governor's plan, called "Arkansas Works," proposes mandatory premium assistance for employer sponsored insurance, a work referral program, and premiums for beneficiaries with incomes above 100% of the federal poverty level. Hutchinson said he will call a special legislative session to consider "Arkansas Works" one week before the State's fiscal session begins in April. The Governor's plan will require three-fourths majority support in the Arkansas House and Senate to become law, after which the State will be required to submit a Medicaid waiver amendment application to the federal government.

Georgia: Legislature Holds Hearing on Coverage Expansion Bill

The State Senate Health Committee held a hearing on Senate Bill 368, legislation proposing a premium assistance program based on Arkansas's "Private Option" that would cover approximately 300,000 Georgians by permitting Medicaid to purchase qualified health plans on the Marketplace and requiring enrollees to spend up to 5% of their income towards the cost of coverage. The program would be contingent upon receiving a federal match consistent with President Obama's proposal to provide non-expansion states that take up the option the same funding algorithm as states that expanded in 2014. Governor Nathan Deal (R) has historically opposed Medicaid expansion and has not commented on the pending legislation.

Idaho: House Committee Denies Funding for Primary Care Access Program

Idaho's House State Affairs Committee rejected a bill that would have partially funded Governor C.L. "Butch" Otter's (R) Primary Care Access Program (introduced previously in a separate bill), according to local media reports. The vote effectively ends the administration's attempt to cover basic primary care services for the approximately 78,000 Idaho adults age 19-64 who earn too much to qualify for Medicaid but not enough to qualify for federal Marketplace tax subsidies. Idaho is among the 19 states that have not expanded Medicaid under the ACA. The bill would have provided $19 million for the program from the State's Millennium Fund (which is funded by a nationwide tobacco settlement) to cover a portion of the program's estimated $30 million annual cost. The source for the remainder of the funding was unclear.

Kentucky: Medicaid Expansion Cuts Low-Income Uninsurance Rate by Two-Thirds, Study Finds

Health Affairs study from the University of Louisville found that that the uninsurance rate among low-income adult Kentuckians was reduced from 35% at the end of 2013 to 11% at the end of 2014, a 68% reduction. The report also found a 16-percentage-point reduction in low-income Kentuckians with unmet medical needs due to cost. The report's release comes amid recent discussion of changes to the State's Medicaid expansion program and the State's insurance Marketplace. Governor Matt Bevin (R) has already begun the process of transitioning the State-based Marketplace, kynect, to HealthCare.gov, and he has formed a committee to lead the redesign of the Medicaid expansion program through a federal waiver.

Wyoming: Senate Votes for Coverage Program for the Uninsured

The State Senate passed a bill that would direct the legislature's Management Council (or its designee) to design a program to "provide greater health status improvements" than those provided by Medicaid for individuals who cannot "afford adequate health care." The bill, sponsored by State Senator Charles Scott (R)—a vocal opponent of of Medicaid expansion—allocates $20,000 for the design of the program and prohibits the State from seeking approval from the federal government to expand Medicaid expansion prior to the legislature's review of the medical assistance program design. Just last week the legislature rejected a bill that would expand Medicaid to Wyoming's estimated 20,000 uninsured.