States confront menu of Medicaid changes

A two-year payment hike for primary care doctors who treat Medicaid patients, called for by the health care law, might not happen without a struggle in Florida. Meanwhile, Kansas waits to hear back from the feds on its proposal to change Medicaid, and New Hampshire officials seek more money for their program.

CQ HealthBeat: Medicaid Payment Rates To Florida Primary Docs May Not Rise Without A Fight
What appeared to be a straightforward -- if temporary -- increase in how much Medicaid pays primary care doctors might not happen without a struggle in the state of Florida. In a letter Tuesday, Rep. Cathy Castor, D-Fla., urged Republican Gov. Rick Scott to heed a Jan. 1 deadline for putting the increase in place. ... The health care law funds a two-year increase in Medicaid payment rates to primary care doctors so they match Medicare levels. But observers say it's not clear that Scott is going to cooperate. There has been considerable back and forth in the state over whether the governor or legislature has to give the go-ahead, observers say (Reichard, 11/27).

Kansas Health Institute News: Still No Word From Federal Officials On KanCare
With little more than a month remaining before the scheduled launch of KanCare, state officials say they still have not heard from federal authorities when -- or if -- they will receive the needed approvals for Gov. Sam Brownback's plan to remake the Kansas Medicaid program…. [Dr. Robert Moser, head of the Kansas Department of Health and Environment] said state officials still see no reason to have a back-up plan prepared in the event the waiver request is rejected or partially rejected or is not approved in time to start KanCare on Jan. 1, as the Brownback administration plans. And he said federal officials had not asked for one (Shields, 11/14).

The Associated Press: NH Health Agency Seeks $321M More In Next Budget
New Hampshire's biggest agency asked Tuesday for $321 million more from state tax sources in the two-year state budget Gov.-elect Maggie Hassan must present to lawmakers in February. Health and Human Services Commissioner Nicholas Toumpas testified at a hearing on the request that one of the biggest increases is due to a change in how the state pays nursing homes for Medicaid care (Love, 11/27).

And states continue to consider the health law's Medicaid expansion --

The Associated Press: Spokesman Says Medicaid Shouldn't Be About Economy
A spokesman for Mississippi's Medicaid program is questioning the notion that expanding the federal-state health insurance program is the way to spur economic growth. Francis X. Rullan says he's speaking only for himself in this instance. But he says it's not a good idea to base an economic development effort on the dependency of a large group of poor or disabled people (Amy, 11/27).

The Lund Report: Oregon Could Reduce Uninsured By 51 Percent Under Medicaid Expansion
Just as Oregon and other states are weighing whether to expand Medicaid, a step made optional by the Supreme Court's June 2012 ruling on the Affordable Care Act (ACA), findings from a new study detailing Medicaid expansion impacts on states may help inform their choices. In Oregon, according to the study -- released by the Kaiser Family Foundation on Nov. 26 and carried out by Urban Institute researchers -- if the state opts to expand Medicaid the ACA will cut the number of uninsured Oregonians by more than 51 percent. This figure is greater than the 47.6 percent reduction in uninsured that the nation as a whole would see if all states expand Medicaid. The ACA, with Medicaid expansion to cover adults at 138 percent of the federal poverty level, the floor set by the ACA and the expansion level researchers used, would constitute "a major impact on Oregon's insurance coverage," said one of the study authors, Matthew Buettgens (Rubin, 11/28).