The politics and policies of the Medicaid expansion

State executives ranging from Louisiana Gov. Bobby Jindal and Wisconsin Gov. Scott Walker to Indiana Gov. Mike Pence and Missouri Gov. Jay Nixon continue to wrestle with their plans regarding the expansion -- and repercussions, in terms of public opinon, budgets and policy decisions -- that are emerging as a result.

The Associated Press: Jindal Says He Won't Reconsider Medicaid Expansion
Gov. Bobby Jindal said Thursday he won't reconsider his refusal to expand Louisiana's Medicaid coverage under the federal health care law, even though a half dozen other Republican governors have agreed to participate. Jindal said he won't include federal funding for a Medicaid expansion in his state budget proposal for the 2013-14 fiscal year, which will be released to lawmakers Feb. 22 (Deslatte, 2/14).

The Washington Post's The Fix: Bobby Jindal's Make-Or-Break Moment
But since then Jindal has made some tough budget choices and has pushed some difficult education reforms. Perhaps most troubling for him right now is his decision to reject a federal Medicaid expansion – a decision the Voter/Consumer Research poll showed is unpopular with the state's voters. Jindal has been out front among Republican governors in rejecting the Medicaid expansion, even as a growing number of GOP governors have decided to take part. In fact, Jindal wrote an op-ed in the Washington Post last month about why he decided to reject the expansion (Blake, 2/14).

The Associated Press: Analyst Says Walker's Health Care Plan Won't Work
Gov. Scott Walker's plan to move more people off state Medicaid plans and onto private insurance through a federal marketplace won't result in cutting the number of uninsured Wisconsin residents in half as promised, an independent analyst said Thursday. Walker's numbers are inflated because poor people near the poverty line won't be able to afford private health insurance that requires individuals to pay for annual deductibles and other cost-sharing expenses, Bob Laszewski, a Washington-based insurance industry consultant, told The Associated Press after reviewing the Republican governor's plan (Bauer, 2/14).

The Associated Press: Pence Pushes State Solutions For Health Care – 'Medicaid Is Broken' He Tells Feds
Indiana Gov. Mike Pence asked the federal government Wednesday to approve a three-year extension of the Healthy Indiana Plan health savings accounts in lieu of an expansion of the federal Medicaid system he called "broken." Pence wrote a fiery letter to Health and Human Services Secretary Kathleen Sebelius on Wednesday saying Medicaid is fraught with "waste, fraud and abuse," while also seeking approval for the HIP extension (LoBianco, 2/14).

The Associated Press: Mo. House Budget Plan Skips Medicaid Expansion
Following through on Republican opposition, the top budget writer for the Missouri House outlined a spending plan Thursday that omits Gov. Jay Nixon's proposed Medicaid expansion. The plan by Budget Committee Chairman Rick Stream also provides a smaller increase for public colleges and universities, early childhood initiatives and various other programs that the Democratic governor had proposed for the 2014 fiscal year (2/14).