Mo. governor wants Medicaid expansion; Other states consider health exchanges

After mulling the controversial decision, Missouri Gov. Jay Nixon said Thursday he wants the state to expand Medicaid, a key part of the health law, but he faces substantial opposition from Republicans who control the legislature. Meanwhile, some states continue to wrestle with issues related to health exchanges.

Kaiser Health News: Capsules: Missouri Governor Backs Medicaid Expansion
Missouri Gov. Jay Nixon wants the state to expand its Medicaid program, marking the strongest stance the Democratic governor has taken to date on the state's pending decision. Nixon previously said he was evaluating the issue to see what's best for Missouri (Gordon, 11/29).

The Kansas City Star: Gov. Nixon Calls For Expansion Of Medicaid In Missouri
Gov. Jay Nixon announced [Thursday] morning that he plans to push lawmakers to expand the public health insurance program for the poor to include an estimated 300,000 uninsured Missourians. The expansion of Medicaid is part of the federal health care law, known as the Affordable Care Act. Missouri Republicans, who hold super majorities in both legislative chambers, have steadfastly opposed the idea. But Nixon, a Democrat, said he's come to the conclusion that the expansion is "the smart thing to do, and it is the right thing to do." … The federal government would pay the additional cost of expansion initially, with states picking up 5 percent beginning in 2017 and 10 percent by 2020. Nixon said his office estimates an additional 300,000 people would be eligible for coverage. Other estimates have ranged from 160,000 to 380,000 newly insured (Hancock, 11/29).

The Associated Press: Mo. Gov. Nixon Backs Expanded Medicaid; GOPs Don't
Breaking months of silence on the subject, Democratic Gov. Jay Nixon on Thursday embraced a broad expansion of Medicaid health care coverage for working adults, but his support was met with immediate criticism by Republican legislative leaders. Nixon had remained noncommittal during his recent re-election campaign about the multi-billion-dollar Medicaid expansion called for under President Barack Obama's health care law. But Nixon said Thursday that he had analyzed the plan since the Nov. 6 election and concluded that expanding Medicaid to an estimated 300,000 additional people was both "the smart thing" and "the right thing to do" (Lieb, 11/29).

Politico Pro: Missouri Governor Says Yes To Medicaid Expansion
Missouri Gov. Jay Nixon announced Thursday he will expand Medicaid in his state, a move that could provide health coverage to approximately 300,000 people. At a news conference at a Kansas City, Mo., medical center, Nixon, a Democrat, said, "My consistent position on expanding Medicaid has been to carefully study the options and then determine what is the best fit for Missouri." Nixon said his budget proposal to the state legislature, which is due in January, will include federal funding for an expansion. But a fight may lie ahead, as he faces Republican majorities in both houses (Smith, 11/29).

St. Louis Beacon: Nixon Makes Strong Push For Medicaid Expansion, Faces Stiff Challenge In GOP-Controlled Legislature
Gov. Jay Nixon announced his full support for expanding the state's Medicaid program, a key provision of the Affordable Care Act that he contends will bolster the state's economic fortunes and help an estimated 300,000 poor Missourians get access to health care. But the Democratic governor's advocacy could face a steep challenge in the Republican-led Missouri General Assembly, unless GOP legislators make an about face from their decision in 2005 to cut eligibility for the health-care program for the poor. When Nixon first campaigned for governor in 2008, he said he would make restoring Medicaid cuts one of his major priorities. But then, after he was elected, he did little -- aside from a failed 2009 effort -- until today (Rosenbaum, 11/29).

In Connecticut, officials are deciding how a health insurance exchange will negotiate with insurers --

CT Mirror: Health Insurance Exchange Won't Negotiate Insurance Rates To Start
Health insurance carriers won't have to negotiate rates to sell their products in the state's new virtual coverage "store." But those running the market -- known as the health insurance exchange -- will develop a plan for ways to drive down costs and promote affordability, which could include negotiation, members of the exchange's board determined Thursday. "This is a huge compromise," said state Healthcare Advocate Victoria Veltri, who had wanted the exchange to have the ability to negotiate rates with insurance carriers from the start. Exchange CEO Kevin Counihan, who had warned that negotiating rates could interfere with the new market's viability, was more pleased. "I think we're very comfortable with it," he said (Becker, 11/29).

Elsewhere, a House legislative committee in Michigan rejects the exchange altogether, and Iowa officials consider if the state should partner with the feds on an exchange --

The Associated Press: House Panel Rejects Michigan-Run Health Exchange
A Michigan House panel on Thursday rejected a proposal to create a state-run online market where people can compare and buy health insurance plans, leaving Michigan to continue down the road of teaming up with the federal government on the mandated health exchange. The House Health Policy Committee defeated the health exchange legislation by a 9-5 vote, with two members abstaining. The state Senate approved a bill, but the House delayed action because its Republican majority had opposed President Barack Obama's federal health care act (Karoub, 11/29).

Politico Pro: Iowa May Opt For Partnership Exchange
Though Iowa Gov. Terry Branstad recently said he wants his state to run its own health insurance exchange, the state's top insurance official predicted that Iowa will start out in a partnership exchange with the feds in 2014. Branstad, in a Nov. 16 letter to HHS, said Iowa preferred to keep the feds away from its exchange, but he also warned he would opt for a federal exchange if he didn't get answers to a list of about 50 question (Millman, 11/29).