Alaska: Legislative Council Drops Medicaid Expansion Lawsuit

The joint legislative council that sued Governor Bill Walker (I) over his executive order expanding Medicaid voted to drop its lawsuit after Superior Court Judge Frank Pfiffner ruled that the House could not substitute itself as the plaintiff in the case. The council's vote effectively ends the lawsuit. Pfiffner dismissed the lawsuit last March, ruling that Governor Walker had the authority to expand Medicaid without legislative approval. More than 17,000 individuals have gained Medicaid coverage since the expansion took effect last September.

Oklahoma: New Revenues and Savings Would Offset Most Medicaid Expansion Costs, Report Finds

A “considerable portion” of the cost of expanding Medicaid in Oklahoma would be offset by new revenues and cost savings generated by an expansion, according to a new report from Manatt Health commissioned by the Oklahoma Hospital Association. The report found that expansion would cost the State $739 million over five years though all but $196 million would be offset by savings and revenue including: increased availability of enhanced federal matching funds for current Medicaid enrollees ($301 million in savings); increased revenue from an existing 3% hospital assessment ($52 million in revenue); and lower general fund spending on uninsured care ($190 million in savings). Additional savings are possible due to CMS’ recent rule expanding the circumstances under which 100% federal funding is available for individuals who receive Medicaid services through the Indian Health Service (IHS). The new rule would lower the State’s cost of insuring both the expansion population and current Medicaid enrollees who access care through the IHS. The study’s findings also do not reflect the broader economic impact of expansion found in states that have expanded Medicaid, including job creation, and increased economic activity and tax revenue. The report estimates that 272,000 individuals would enroll in the new adult group under Medicaid expansion in 2019 after a “ramp-up” period.

Tennessee: Task Force Proposes Phased Medicaid Expansion

The Legislature’s health care task force has proposed expanding Medicaid to individuals with incomes up to 138% of FPL in two stages: first to military veterans and individuals with mental illness or substance abuse disorders, then to all individuals. The task force did not release a written version of the plan, though media reports indicate the program encourages integrating behavioral and physical health treatment and “includes a work and education component.” The second phase of the expansion would be contingent on the success of the first phase, based on metrics that may include costs per member, enrollment levels, health outcomes and emergency room utilization. Task force chairman Cameron Sexton (R) said he expects there will be several months of negotiations with the federal government prior to presenting the proposal to the Legislature. Separately, the federal government authorized a two-month temporary extension of the State’s Medicaid managed care waiver, while State and federal officials continue to discuss uncompensated care pools, according to Modern Healthcare.