Post-Election Reactions and Activity in the States

Arizona: Former Governor Voices Support for Medicaid Expansion

Former Governor Jan Brewer (R), who served from 2009 to 2015, is encouraging President-elect Donald Trump to support Medicaid expansion and to examine Arizona’s model in particular, according to the Associated Press. Brewer noted that approximately 400,000 Arizonans have gained insurance since the State expanded Medicaid in 2014.

Arkansas: Governor Expects Greater 1115 Waiver Flexibility, Offers No Comment on Expansion

Governor Asa Hutchinson (R) said in the short-term he anticipated greater flexibility to implement changes through the State’s 1115 waivers, possibly including work requirements and cost-sharing. “It’s going to take some time,” Governor Hutchinson said, “but I expect fairly significant and dramatic changes in reference to health care policy and its relationship to states in the future.” The Governor would not speculate on whether Medicaid expansion should remain in effect if parts of the ACA are repealed.

Georgia: Legislature Will Not Consider Expansion

State House Speaker David Ralston (R) said that it no longer makes sense to consider Medicaid expansion. “I would not think it’s the thing for us to do to jump on a sinking ship,” Ralston said. “We will look at what steps we need to move forward to give people a realistic health care policy rather than an empty promise which is what this entire experiment has been.” In August, the Georgia Chamber of Commerce presented three “conservative-friendly” expansion proposals.

Iowa: Governor Notes Uncertainty on Medicaid Expansion

Governor Terry Branstad (R) said it was not clear whether the State would maintain its Medicaid expansion, but that he thought it unlikely that the 145,000 expansion adults would lose their coverage entirely, according to Radio Iowa.

Kansas: Hospital Association to Pursue Medicaid Expansion in Light of Changes in Legislature

The Kansas Hospital Association (KHA) said it will advance a Medicaid expansion bill during the 2017 legislative session in light of recent wins in the Legislature by pro-expansion Republicans and Democrats. Lieutenant Governor Jeff Colyer (R) indicated the Governor’s office would be willing to work with the Legislature "to create a Kansas solution that makes health care more affordable and available to Kansans." Governor Sam Brownback (R) has historically opposed expansion, though in February 2016 indicated a willingness to consider a Medicaid expansion program if it met certain requirements, such as budget neutrality. Last legislative session, the KHA crafted a Medicaid expansion plan modeled after Indiana's expansion program, but it was not adopted.

Kentucky: State Continues Expansion Waiver Negotiations With CMS

Governor Matt Bevin (R) has said his administration will continue negotiations with the federal government over its pending Medicaid expansion waiver request. He, however, has not changed his perspective on the ACA as a whole, saying that the day that the law is “gone” will be “a good day.”

Louisiana: Governor Anticipates Medicaid Expansion to Remain in Place

Governor Jon Bel Edwards (D) said he was optimistic the State’s Medicaid expansion program would remain in place. "I just don't believe at the end of the day that the new President or Congress will cause all these people around the country to lose their coverage," he said.

Michigan: Governor Aims to Maintain Medicaid Expansion Program

Governor Rick Snyder (R) indicated he will seek to sustain the State’s Medicaid expansion next year. A spokesperson for the Governor said, “Going forward we will work closely with the federal government to convey the successes of Healthy Michigan and the 600,000-plus Michiganders it is serving."

Nebraska: Lawmakers Suspend Medicaid Expansion Efforts

Nebraska lawmakers, who have introduced four different Medicaid expansion bills since 2013, announced they will no longer pursue expansion in the 2017 legislative session in light of uncertainty about the future of the ACA.

Ohio: Medicaid Expansion to Be Included in Upcoming Two-Year Budget

The director of the Governor’s Office of Health Transformation said the State will maintain Ohio’s Medicaid expansion in its upcoming two-year budget plan.

South Dakota: Governor Abandons Expansion Efforts

Governor Dennis Daugaard (R), whose administration had worked to expand Medicaid, said he will no longer pursue Medicaid expansion in his State after a discussion with Vice President-elect Mike Pence. His administration intends to work with President-elect Donald Trump and the State’s congressional delegation to leverage new federal policy changes restructuring the Medicaid program.

Tennessee: Health Reform Task Force Chair Anticipates Greater Flexibility Under New Administration

State Representative Cameron Sexton (R), chairman of a health reform legislative task force that had been crafting an alternative Medicaid expansion proposal, said the new Administration will likely provide Tennessee more flexibility in Medicaid and potentially a block grant. “We think under the new administration we will be better able to create a better Tennessee solution to the health care issue,” said Sexton.

Utah: Negotiations Continue With CMS Over Limited Medicaid Expansion, Delayed Start Likely

Utah officials will continue to negotiate details of its limited expansion of Medicaid coverage with CMS, though CMS is expected to request changes to the program that will likely delay implementation past the original January 1, 2017 start date, according to the Salt Lake Tribune. Utah's expansion plan is a limited extension of Medicaid coverage to approximately 16,000 Utahns, predominantly those living in extreme poverty, including the chronically homeless and those involved in the criminal justice system.

Other State News

New Hampshire: CMS Rejects Waiver Request for Work Requirements, Additional Eligibility Verification

CMS turned down New Hampshire's request to amend its 1115 waiver to include a requirement that unemployed, newly eligible able-bodied adults without children “engag[e] in at least 30 hours per week…of employment and training activities.” CMS also rejected the State's request to require newly eligible adults to verify U.S. citizenship with two forms of identification and prove New Hampshire residency, as well as to require hospitals that serve newly-eligible Medicaid beneficiaries to also provide medical services to beneficiaries of veteran health programs.