Arkansas: Medicaid Expansion Worth up to $757 Million

Up to $757 million over the next five years hangs in the balance if Arkansas opts not to renew its Medicaid expansion, according to an updated estimate prepared by The Stephens Group for Arkansas's Health Reform Legislative Task Force. This estimate, an increase over projections released in August 2015, is said to be a result of lower-than-expected program costs and a greater number of traditional Medicaid beneficiaries transferring to the expansion group (which has a higher federal matching rate and thus results in lower state spending). The Legislature is expected to consider Governor Asa Hutchinson's (R) Medicaid expansion plan, called Arkansas Works, during a special legislative session in early April. Governor Hutchinson said failure to approve Arkansas Works would lead to additional cuts to the State budget. The plan will require three-fourths majority support in the House and Senate and CMS approval.

Colorado: Medicaid Expansion Positively Impacted Economy, Trend Expected to Continue

Since Medicaid expansion was implemented, Colorado has added 31,000 jobs, raised annual household earnings by nearly $650, and added $3.8 billion to the State economy, according to a new report commissioned by the Colorado Health Foundation and prepared by the Futures Center at Colorado State University. The report projects that by fiscal year 2034-2035, Medicaid expansion will have added approximately 43,000 new jobs to the State, raised average annual household earnings by $1,033, and added a total $8.5 billion to the State economy, which will increase General Fund revenue from $102.4 million to $248.3 million. The General Fund is not expected to incur any additional expenses due to expansion.

Indiana: Legislature Votes to Establish Authority Over Medicaid Expansion

The State House and Senate passed a bill that would require legislative approval to make modifications to the State's Medicaid expansion program, Healthy Indiana Plan 2.0, which is authorized through a demonstration that will require renegotiation prior to its expiration in 2018. According to supporters, the bill is designed to strengthen the State's position for renegotiating the terms of the waiver with the federal government. Governor Mike Pence (R), who is up for re-election this year and is expected to sign the bill into law, said he wants to ensure the State "has a solid legal framework" for the program before entering into those negotiations, especially considering uncertainty regarding the federal administration after the election.

New Hampshire: House Approves Medicaid Expansion Renewal With Modifications

New Hampshire's House voted to renew the State's Medicaid expansion program through 2018, with several new requirements, including that enrollees be employed or in pursuit of work and pay co-pays for non-emergency visits to the emergency room. The bill, however, includes a severability provision that would permit renewal of the program even if CMS does not approve some of the new requirements, including work status. The bill funds the expansion through three sources of funding: the insurance premium tax on health plans that serve expansion enrollees, voluntary donations from acute care hospitals and transfers from the State's high risk pool. The program would be repealed in the event that these funding sources were not sufficient to cover the State's share of the costs. The bill now heads to the Senate, where reauthorization is expected.

New York: $1.5 Billion Distributed to DSRIP Providers for Capital and Infrastructure Support

Governor Andrew Cuomo (D) announced $1.5 billion in grant funding through the Capital Restructuring Financing Program and Essential Health Care Provider Support Program, which supports implementation of the State's Delivery System Reform Incentive Payment Program (DSRIP). Grants will sponsor infrastructure improvements, IT system development, debt relief at hospitals and clinics, and projects ineligible for funding through the State's $7 billion DSRIP initiative but which are considered vital to the program's success. The long-awaited capital funding, originally earmarked in the State's 2014-2015 budget, will fund 162 projects at hospitals and clinics throughout the State.

Utah: Senate Sends Limited Medicaid Coverage Plan to the Governor

After years of legislative battle, the Utah Senate approved a very limited extension of Medicaid coverage to approximately 16,000 Utahns, which is significantly fewer than the 125,000 that would have been covered under several failed Medicaid expansion plans. The plan predominantly targets Utahns living in extreme poverty, including the chronically homeless and those involved in the criminal justice system, guaranteeing coverage for at least 12 months. The State will spend $30 million on the program, 45% of which will be provided by hospitals, and will draw down $70 million in federal funds, with a significantly lower federal matching rate than would have been provided through traditional expansion. Democratic lawmakers who had supported the ACA's Medicaid expansion expressed frustration with the plan, saying that while it helps Utah's most needy, it is fiscally unwise and leaves thousands of low-income Utahns without coverage. The bill now goes to Governor Gary Herbert (R) who is expected to sign it, after which the State will begin the process of seeking a federal waiver.