House Brings Medicaid Expansion Lawsuit to State Supreme Court

The Alaska House of Representatives has filed an appeal to the State Supreme Court seeking reinstatement of its lawsuit against Governor Bill Walker's (I) executive order expanding Medicaid, according to the Alaska Daily News. Alaska's Independent Democratic Caucus has said the House, which did not formally vote on whether to pursue an appeal, could not legally appeal without a vote. A Superior Court judge dismissed the lawsuit in March, ruling that the Governor had the authority to expand Medicaid without the Legislature's support.


State Releases Medicaid Expansion Waiver Extension for Public Comment

The Department of Human Services released a draft 1115 waiver extension application to implement Arkansas Works, a plan to extend and reform the State's Medicaid expansion, for a 30-day public comment period prior to submitting the request to CMS. The program, which the Legislature authorized last month, seeks to institute mandatory premium assistance for beneficiaries with access to cost-effective employer-sponsored insurance, premiums for beneficiaries with incomes above 100% of FPL, an incentive system to encourage premium payment and healthy behaviors, and referrals for job training for individuals with no income. Arkansas plans to submit the waiver extension request to CMS this summer which, if approved, will take effect January 2017.


Opioid Task Force Recommends Health Coverage Expansion

The Maine Opiate Collaborative released a comprehensive set of recommendations to counter the State's opioid crisis, including "support expanded access to healthcare coverage, the federal health exchange and Medicaid for people with mental health and substance use disorders." Expanded Medicaid coverage is unlikely given Governor LePage's staunch opposition. Other recommendations include creating a high level position to coordinate a comprehensive approach across state and local government and enhancing Maine's Prescription Monitoring Program by soliciting input on its implementation from the provider community and ensuring the program is adequately staffed. The Opiate Collaborative was established in August 2015 by Governor Paul LePage (R) to bring together experts in law enforcement, education, prevention, harm reduction and treatment. The committees' recommendations are based on participation in 22 public forums held throughout Maine.

South Dakota

Estimated Medicaid Expansion Savings up $18 Million After Changes in IHS Policy; Potential for Special Session Continues

The State has increased its projected cost savings from Medicaid expansion, from $67 million to $85 million, as a result of CMS's new policy that broadens the scope of services for Medicaid-eligible American Indians (AI) and Alaska Natives (AN) for which the federal government will fully reimburse. State Health Secretary Kim Malsam-Rysdon noted that the Governor may call a special session to consider Medicaid expansion based on the increase in the projected savings.


Waiver Application for Limited Expansion Plan Defines Newly Eligible

The Department of Health (DoH) released a draft 1115 waiver application to expand Medicaid coverage to parents up to 55% of FPL and childless adults with no income who meet one of three eligibility criteria: (1) are chronically homeless; (2) are involved in the criminal justice system and in need of substance use or mental health treatment; or (3) are discharged from a state hospital or participate in Utah's General Assistance Program and need substance abuse/mental health treatment. The limited Medicaid expansion, approved by the Legislature in March, would enroll up to 16,000 low-income, uninsured Utahns beginning January 1, 2017. Because it is a limited expansion, it would not be eligible for the enhanced federal matching funds. The DoH plans to submit the waiver for federal approval by July 1, and will host three public hearings and accept public comment through June 8.


Governor Vetoes Budget Restriction on Expanding Medicaid

Governor Terry McAuliffe (D) signed the State's 2016-2018 biannual budget and line-item-vetoed a provision that would have invalidated all State appropriations if the governor expanded Medicaid without the permission of the State's General Assembly. The Governor's spokesman said the Governor is not planning to expand Medicaid unilaterally, but that the administration continues to assess opportunities to "bring this money home." House Speaker William J. Howell (R) contested the validity of the line-item veto, stating that "the Governor cannot veto conditions attached to appropriations without vetoing the appropriation" itself.

National News

Medicaid Expansion States Saw Greater Increases in Medicaid/CHIP Participation Among Children

Medicaid/CHIP participation rates for children increased faster between 2013 and 2014 in states that expanded Medicaid (3%) compared to non-expansion states (1.8%), according to an analysis of American Community Survey data by the Urban Institute. Researchers also found that the 10 states with the largest participation gains in 2014 all expanded Medicaid that year, and that the differential in uninsured but eligible children between expansion and non-expansion states increased between 2013 and 2014. The report considers that the increased availability of Medicaid for adults in expansion states may have positively impacted children's enrollment in Medicaid/CHIP (the "woodwork effect"), though it concludes that more research is needed to determine the extent of that impact.