States worry over Medicaid expansion; Montana expands kids coverage

State officials continue to worry about additional costs that would stem from a Medicaid expansion. Meanwhile, Montana unveils a plan to expand health insurance for children and Iowa Republicans are touting their own alternative to a federal health care overhaul.

"Assurances from the U.S. Congress that states will not be saddled with extra costs from a nationwide healthcare reform plan have done little to relieve the nervousness rippling through state legislatures and governors' offices," Reuters reports. In a letter to the Senate Finance Committee, The National Conference of State Legislatures "demanded that any type of [Medicaid] expansion be reimbursed 100 percent by the U.S. government." States are also "worried that the plan will require all Americans to have insurance.There are 6 million Americans who are currently eligible for Medicaid but are not enrolled, according to Vermont Governor Jim Douglas. They would likely sign up for Medicaid if that requirement becomes law, also stretching states' budgets." The Congressional Budget Office has said that by 2019 the health care plan would add 11 million people to Medicaid enrollment (Lambert, 9/23).

Montana: The Associated Press/Great Falls Tribune reports that "[s]tate officials unveiled a plan Wednesday to quickly and dramatically expand government health insurance to children following the Oct. 1 implementation of the voter-approved Healthy Montana Kids program. The initiative was approved by a large margin last November. It combines the previously separate Children's Health Insurance Program and Medicaid for children, while significantly simplifying the application and administration process.  In total, the two programs currently serve about 70,000 kids. The Department of Public Health and Human Services estimates another 30,000 could be added under the new program for $112 million over the next two years. Of that, about a fifth is paid for by the state and the rest comes from federal programs" (Gouras, 9/24).

Iowa: Iowa Public Radio reports that state "Republicans are traveling the state today offer an alternative the federal healthcare reform plan." Their plan "would provide low-cost catastrophic health plans for uninsured people under 30 — which (they say) includes half the uninsured in Iowa. They would also focus on affordability, including medical malpractice and tort reform, and would expand the health insurance tax deductibility to individuals and all small businesses" (Danielson, 9/23).