States continue tussling with Medicaid expansion plans

CQ HealthBeat reports that even in jurisdictions that opt not to pursue the Medicaid expansion, the number of people who are left without insurance coverage will not be as large as expected. Meanwhile, Arkansas Gov. Mike Beebe signed his state's private insurance option plan into law while debate is ongoing in Pennsylvania, Texas, Florida and South Dakota.

CQ HealthBeat: In States That Don't Expand Medicaid, One Of Four Uninsured Poor May Still Get Coverage
Advocates for the poor are alarmed that if states do not expand their Medicaid programs under the health care law, millions of uninsured Americans will continue to go without coverage next year. There's no doubt that's true. But the size of the group that will go without isn't as big as one might think (Reichard, 4/24).

Reuters: Arkansas Governor Signs Private Insurance Option Into Law
Arkansas's Democratic governor signed into law on Tuesday a plan to extend health insurance to more of the state's low-income residents in a move that could offer a model for other states wrestling with opposition to the federal government's Medicaid expansion plan. The Arkansas law uses federal Medicaid funds to buy private insurance for about 250,000 state residents who earn up to 133 percent of the poverty line, or $15,415 per year (Parker, 4/23).

The Associated Press: Beebe Signs 'Private Option' Plan Into Law
Arkansas Gov. Mike Beebe on Tuesday signed into law a plan to use federal Medicaid money to purchase private insurance for thousands of low-income workers, and state officials said they will now work to get final federal approval for the proposal (DeMillo, 4/23).

Kaiser Health News: Capsules: Insurer Centene: We Can Do Arkansas-Style Medicaid
Last week the Arkansas legislature approved a plan to give Medicaid beneficiaries money to buy individual policies from private insurers on the state's health insurance exchange -; the subsidized, online marketplaces due to be in business next year. The governor signed the bill Tuesday -; making it law. The Department of Health and Human Services, which has said it "will consider approving a limited number" of such arrangements, still needs to negotiate details and sign off. One insurer is already expressing interest" (Hancock, 4/23).

The Associated Press: Pa. Legislature's Analysts See Benefit In Medicaid
An expansion of Medicaid eligibility under a 2010 landmark federal health care law would boost the state's finances by hundreds of millions of dollars a year, the Pennsylvania Legislature's nonpartisan fiscal analysts said Tuesday. The report echoes the conclusions of previous studies sponsored by health care groups that support a Medicaid expansion (Levy, 4/23).

Philadelphia Inquirer: Independent Agency Sees Savings In Medicaid Expansion
A new analysis by the state's Independent Fiscal Office says the proposed expansion of Medicaid under the federal Affordable Care Act (known popularly as Obamacare) will dramatically boost the Pennsylvania economy and help the state's budget rather than hurt it­ – contrary to the fears of Gov. Corbett, who has so far balked at the expansion, in spite of a federal commitment to pick up the bulk of the costs (Warner, 4/23).

KYW Philly: Supporters And Opponents Weigh In On Medicaid Expansion In Pennsylvania
A new report from an independent agency created by the state legislature, and a warning from the state welfare secretary, add to the debate over whether Pennsylvania should opt for Medicaid expansion under the new federal health care law. The Independent Fiscal Office analysis of Medicaid expansion adds to other previous studies that project significant benefits for Pennsylvania. But Governor Corbett has said all along that he's concerned about whether long-term assumptions are accurate (Romeo, 4/24).

The Associated Press: House Could Be On Way To Medicaid Fight
Another -; and perhaps final -; fight over Medicaid expansion may be on the horizon in the Texas Legislature. Despite notable reluctance and the House instructing budget negotiators this week to not even consider voting on Medicaid proposals, a House panel on Tuesday cleared the way for the full chamber to debate drawing down millions of federal dollars to provide health care for more low-income Texas residents (Weber, 4/23).

The Texas Tribune: House Panel Advances Zerwas' Medicaid Proposal
Despite opposition from conservative Republicans, the House Appropriations Committee on Tuesday advanced a proposal that would reform Medicaid by allowing the state to request a block grant from the federal government and expand coverage to low-income Texans… Members of Appropriations voted 15 to 9 to move the legislation out of committee and continue debate on the House floor (Aaronson, 4/23).

Houston Chronicle: House Committee Advances Medicaid Alternative Bill
House budget-writers approved a bill Tuesday meant to draw down billions of federal health-care dollars without, they insist, expanding Medicaid. The Appropriations Committee voted 15-9 for House Bill 3791 by Rep. John Zerwas, R-Simonton, which would express a preference for a Medicaid block grant. If the block grant were denied, as is expected, the legislation would rely on buying private insurance policies for the neediest Texans who otherwise would be covered under Medicaid expansion (4/23).

Austin American Statesman: Divided Panel OKs Medicaid Bill; House Fight Likely
Setting the stage for a raucous vote in the Texas House, a divided Appropriations Committee approved a bill Tuesday that rejects Medicaid expansion in favor of private market strategies for insuring low-income Texans. After a rushed morning meeting that featured little debate, the chamber's largest committee voted 15-9 to approve the bill by Rep. John Zerwas, R-Simonton. All no votes were from Republicans, including several who said they felt hurried and wanted a longer committee debate. ... Conservative Republicans in the House have made it clear that they will oppose any attempt to increase the state's Medicaid rolls, a key provision of the Affordable Care Act, the reform law many call Obamacare, and Tuesday's committee vote showed that many remain skeptical of any related measures (Lindell, 4/23).

Associated Press/Miami Herald: Fla. House, Senate Not Budging On Medicaid Plans
Sen. John Thrasher, one of the top ranking Republicans in the Senate, predicted Monday the Senate will vote on a bill by Sen. Joe Negron. It would provide health coverage to roughly 1.1 million Floridians, drawing down an estimate $51 billion in federal funds over the next decade and giving that money to residents to purchase private health insurance. House Republicans, however, have thumbed their nose at any proposal that would accept money tied to the so-called "Obamacare." "The Florida Senate never waves the white flag," Thrasher said. "That would be an embarrassment to wave the white flag." Seeking a compromise, Republican Sen. Aaron Bean proposed a plan that won approval from the Senate's budget panel Monday. It would bypass federal dollars and spend state money to provide health coverage to roughly 115,000 residents. Bean urged colleagues to pass it, "just so we can keep our options open." But Thrasher said the Senate does not plan to take up Bean's bill on the floor or endorse the House approach (Kennedy and Fineout, 4/23).

Tampa Bay Times: Tweaked Medicaid Billing System For Counties Headed To Senate Floor
The Senate budget committee agreed to phase in a new Medicaid billing system for counties over seven years instead of five. But that didn't stop county commissioners from across the state from speaking out against the legislation. Senate Bill 1884 is headed for a floor vote but could see additional tweaks before then. Senators said the proposal may not be perfect right now, but it's their best attempt to create a new system to collect counties' share of Medicaid costs. Sen. Arthenia Joyner, D-Tampa, voiced concerns but still voted in favor of the bill (Mitchell, 4/23).

The Associated Press: SD Health Care Workers Urge Medicaid Expansion
A doctor, directors of medical facilities and other health care workers told a state task force Tuesday they believe South Dakota should expand its Medicaid program to provide health insurance to thousands more low-income people. They said low-income people without health insurance now delay getting medical care until they are seriously ill because they know they cannot pay the bill (Brokaw, 4/23).