New Medicaid era takes different paths in Mich., Wis.

The neighboring states opt for different approaches to Medicaid expansion. Meanwhile, in Missouri, two Republican lawmakers clash over whether to accept the health law's expansion, and the Pennsylvania governor says he is nearly ready to pull back his proposal that is languishing with federal officials.

The Washington Post's Wonkblog: Michigan And Wisconsin Highlight Divide On Medicaid Expansion
While the health care world was fixated yesterday on the end of Obamacare open enrollment, Tuesday also marked the beginning of a new Medicaid era for two neighboring states that took very different approaches to the law's expansion of coverage for low-income individuals. In Wisconsin, Republican Gov. Scott Walker pared back generous Medicaid eligibility while opening up the program to more of the state's lowest-income adults. In Michigan, Gov. Rick Snyder is using a federal waiver to implement the Affordable Care Act's expansion (Millman, 4/2).

The Associated Press/Kansas City Star: Missouri Medicaid Bill Set Aside After GOP Dispute
A bill revamping the management of Missouri's Medicaid program was set aside Wednesday after debate turned tense between two Republican senators who are at odds over whether to accept billions of federal dollars to expand health coverage for low-income adults (Lieb, 4/2).

St. Louis Post Dispatch: Republican Floats New Way To Expand Medicaid In Missouri, Runs Into Roadblock
Sen. Ryan Silvey, R-Kansas City, said Wednesday that it's time for the Missouri Legislature to work to solve problems created by the federal Affordable Care Act instead of just hoping Congress will repeal it. Silvey contends he has a way to solve one of those problems. ... But at least so far, his plan isn't even on the table. And critics of the health care law, led by Sen. John Lamping, R-Ladue, hope to keep it that way (Young, 4/2).

Springfield (Mo.) News-Leader: Medicaid Proposal Sparks Heated Exchange In Senate
Two Republicans dueled over Medicaid this morning, as the Senate's foremost opponent of expansion accused another senator of taking the "easy" route in rolling out a plan that would increase coverage. Sen. Ryan Silvey, R-Kansas City, has a proposal that would provide insurance for adults earning up to 138 percent of the federal poverty line but would also make extensive changes to assistance programs for the poor. ... On the floor, Sen. John Lamping, R-St. Louis County, said Republican lines such as "pragmatism" and "problem-solving" operate as code words that allow conservatives to support policies that lead to more government and more debt (Shorman, 4/2).

Philadelphia Inquirer: As Medicaid Talks Stumble, Corbett Warns Of 'Breaking Point'
Gov. Corbett said Wednesday that he might be nearing a decision on whether to pull the plug on his proposal to offer health insurance for hundreds of thousands of uninsured Pennsylvanians. In his strongest statement on the yearlong Medicaid negotiations, Corbett said he was "reaching his breaking point" with the federal government (Worden, 4/2).

The Billings Gazette: Court Clears Initiative Opposing Medicaid Expansion
The [Montana] Supreme Court on Wednesday denied an attempt to block state officials from approving petitions for an initiative prohibiting Montana from using funds or staff to administer the Affordable Care Act and forbidding the state from expanding Medicaid. The court, in a 5-0 ruling, rejected an attempt by Travis Hoffman, of Missoula; Melissa Smylie, of Great Falls; and Kim Abbott, of Helena, to disqualify Initiative 171 and prevent it from being circulated for signatures to qualify for the November ballot. Hoffmann is on Medicaid, while Smylie is on Medicaid and her child is on the Children's Health Insurance Program. Abbott is leader of the Healthy Montana initiative (Johnson, 4/2).