How the Medicaid ruling is playing in the states

State officials offer views on their newfound options regarding the health law's Medicaid expansion. Also, news outlets report on how many people might become eligible for Medicaid and at what cost. 

Georgia Health News: Weighing Impact On Medicaid Expansion, Exchange
Gov. Nathan Deal  said Thursday that it's too early for the state to make a decision on whether to expand Medicaid or create its own health insurance exchange, if the Affordable Care Act (ACA) survives a renewed Republican effort to repeal it. Deal, expressing dismay over the Supreme Court ruling that largely upheld the health law, called for its repeal by Congress. He said at a press conference that he did welcome the part of the court ruling that left it up to the states whether they would expand their Medicaid programs to cover more low-income residents (Miller, 6/28).

Richmond Times-Dispatch: Virginia Faces Key Decisions On Special Session, Medicaid
Virginia political leaders and lawmakers may not like the U.S. Supreme Court ruling to uphold federal health care reform, but they face big decisions soon on how to carry out the law in a national election year. The most immediate decision is whether to call a special legislative session this year on creating a state exchange for health benefits. The ruling also gives Virginia an unexpected choice on whether to expand its Medicaid program to cover hundreds of thousands of uninsured Virginians. Calling the court's decision "extremely disappointing for Virginia and for America," Gov. Bob McDonnell said the state will evaluate the steps necessary to comply with the Patient Protection and Affordable Care Act. "While we have awaited this decision, planners have been working to identify necessary resources and issues to be addressed to ensure Virginia implements this flawed law in the most effective and least costly and burdensome way possible," he said in a statement immediately after the ruling Thursday (Martz and Meola, 6/29).

Arizona Republic: Health Care Ruling Could Mean Coverage For Hundreds Of Thousands Of Uninsured Arizonans
Arizona Gov. Jan Brewer and state lawmakers face a key decision in the wake of the U.S. Supreme Court upholding the federal health-care law's broad expansion of Medicaid: They can extend health insurance to more than 300,000 low-income Arizonans at a cost of $250 million for the first year or opt out of the largest expansion in Medicaid's nearly 50-year history. Brewer is expected to confer with health-care officials in the coming weeks before deciding (Reinhart, 6/28).

The Houston Chronicle: Health Law Ruling Leaves Uninsured Texans In Limbo
The 6.5 million Texans without health insurance faced a future of hope tempered with uncertainty Thursday, as the U.S. Supreme Court ruled that most of the health care reform law was valid but left a key provision up to the states…..But the ruling left plenty of questions unanswered, including whether Texas will participate in a program to expand Medicaid coverage - if it doesn't, as many as 1.5 million low-income people will remain uncovered - and whether, and how quickly, it will set up the health insurance exchange intended to make it easier to shop for insurance. Texas did little to prepare for the law (Kever and Ackerman, 6/28).

The Dallas Morning News: Health Law Ruling Means Texas Could Reject Medicaid Expansion, But At A Cost
The U.S. Supreme Court's decision on the health law gives Texas an opportunity to opt out of a massive expansion of Medicaid that would enroll as many as 1.5 million more adults in the program….The opinion is likely to prompt some Texas conservatives to demand that Texas opt out of the Medicaid expansion. That choice is likely to become a major part of the Legislature's agenda when it meets in January (Michaels, 6/28).

Detroit Free Press: Medicaid Expansion: Up To 500,000 More People Will Be Covered In Michigan
Among the provisions of the law: As many as a half-million more of Michigan's lowest-income residents will get government-funded Medicaid insurance as it expands under health care reform in 2014 -- an expected influx on top of the 1.9 million already in the program. … The better system is one in which consumers purchase an affordable Medicaid plan that works as a health savings account of sorts -- ensuring patients are more thoughtful about accessing care, said Dr. Matt McCord, an Ann Arbor anesthesiologist and member of Docs4PatientCare, a national group of doctors fighting the new law. The Supreme Court ruling is a reminder that the state needs to be careful about how it expands its program, McCord said (Erb and Anstett, 6/29).

CNN Money: Medicaid Expansion: Many Could Be Left Out
The Supreme Court may have upheld health care reform, but the ruling has left many of the poorest Americans at risk of remaining uninsured. The justices' decision Thursday kept in place nearly all of the Affordable Care Act's provisions, including the mandate that all consumers buy health insurance by 2014 or pay a tax. Also upheld was a provision that expands Medicaid coverage to include all adults with annual incomes at or below 133% of the federal poverty level, which is currently $14,404 for an individual. The federal government will pick up the total cost of the expensive expansion for the first three years, after which the funding will phase down to 90%. The expansion could reduce the number of uninsured adults with incomes under 133% of poverty by more than 11 million by 2019, according to a Kaiser Family Foundation estimate (Luhby, 6/29).

Des Moines Register: Will Branstad Resist Letting 150,000 More Iowans Onto Medicaid?
Iowa Gov. Terry Branstad declined to immediately say whether he would resist an expansion of Medicaid, which the U.S. Supreme Court ruled today cannot be forced on states. … Branstad spokesman Tim Albrecht said today that his office couldn't immediately comment on how the governor might handle the matter (Leys, 6/28).

Health Policy Solutions (a Colo. news service): Supreme Court Ruling Clears Way For Sweeping Health Reform
In Colorado, the ruling clears the way for sweeping multi-million dollar health reform to move forward. Only one part of the massive law appeared to be in doubt. Analysts in Colorado and around the country were trying to figure out exactly how the ruling on Medicaid expansions would affect them. … Gov. John Hickenlooper said in a statement that millions of Coloradans have already benefited from the Affordable Care Act (ACA) including thousands of young adults and people with pre-existing conditions who have been able to qualify for health insurance, seniors who have taken advantage of preventive screenings, and hundreds of thousands of Coloradans who no longer have lifetime limits on their health coverage (Kerwin McCrimmon, 6/28).