Medicaid expansion challenges: Which states are facing roadblocks, running out of time?

News outlets report on recent events in Florida, Ohio, Texas, Arizona and South Carolina.

The Washington Post's Wonk Blog: 'The Outlook For Medicaid Expansion Looks Bleak'
Twenty states and the District of Columbia have agreed to expand their Medicaid programs, to cover everyone under 133 percent of the federal poverty line. That leaves 30 states that haven't, although Avalere categorizes four states as leaning in that direction (Tennessee, Kentucky, Florida and New York). Some of these states have especially large uninsured populations. Texas, for example, has an estimated 1.8 million people who would be expected to enroll in Medicaid under the expansion (Kliff, 4/25).

Kaiser Health News: With Time Running Out, Florida Medicaid Expansion Is In Doubt
When the U.S. Supreme Court upheld the health law last year … the justices made the expansion of Medicaid voluntary. Of the 27 million people projected to gain coverage under the law, about 13 million are expected to do so through Medicaid. … Fourteen states, many in the Republican-controlled South, have already rejected the Medicaid expansion, while 20 have agreed to comply with the law, according to consulting firm Avalere Health. Florida, with nearly four million uninsured residents, is one of more than a dozen still weighing the issue. And just as it has an outsized impact on presidential elections, it is likely to play a significant role in the success of the 2010 health law (Galewitz, 4/26).

The Associated Press: House Shoots Down Plan To Offer Health Care To 1M
The Florida House rejected an amendment Thursday that would have accepted tens of billions of federal dollars and provided health coverage to an estimated 1.1 million residents, setting up a standoff between the House and Senate in the final week of the legislative session. Republican Rep. Mike Fasano sponsored the amendment in hopes of ending a legislative stalemate and extending coverage to hundreds of thousands more Floridians (Kennedy and Rosica, 4/25).

Health News Florida: House Says No To Fasano, Federal Funds
State Rep. Mike Fasano, a longtime Republican legislator from New Port Richey, pleaded with his GOP colleagues to vote for the Senate's "bipartisan plan" to cover 1.1 million low-income uninsured Floridians. Fasano begged them to "bridge the aisle" that separates the political parties in Tallahassee. ... But House leaders said that was a bridge too far (Gentry and Watts, 4/25).

The Miami Herald/Tampa Bay Times: Hope For Health Care Compromise Dwindles
House Republicans rejected a bipartisan Senate proposal to accept $51 billion in federal health care money on Thursday, diminishing hopes that lawmakers will reach a health care compromise before the legislative session ends next week. After five hours of targeted questions and impassioned debate, Republicans rejected an attempt by renegade Republican Rep. Mike Fasano to accept the Senate plan to provide federally subsidized health coverage to more than 1 million Floridians (Mitchell, 4/25).

The Associated Press: Medicaid Expansion Plan In Ohio Takes Another Hit
Gov. John Kasich's plan to expand Medicaid health insurance coverage to more low-income Ohioans as part of the state budget has come up against another roadblock from Republicans who control the Legislature. The Senate's version of the state budget won't include the governor's proposed Medicaid expansion, Senate President Keith Faber said Wednesday, but he said that Medicaid "reform" is not dead in Ohio (4/25).

The Texas Tribune: Janek Awaits Direction From Lege On Medicaid Expansion
Texas Executive Health Commissioner Kyle Janek clarified on Thursday why negotiations between the federal government and the Health and Human Services Commission on whether to expand Medicaid are at a standstill: He's waiting on the Legislature (Aaronson, 4/25).

Arizona Republic: Feds Say No To Funding A Leaner Arizona Medicaid
Federal health officials dealt a blow to opponents of Medicaid expansion Thursday, saying they're unlikely to fund a slimmed-down version of the state's indigent-health-care program as the political battle over the issue intensified. Gov. Jan Brewer declared the federal announcement a game-changer in the debate, which is holding up a new state budget. She told GOP legislative leaders to stop delaying a vote on Medicaid expansion and move swiftly to present her expansion plan to lawmakers (Reinhart, 4/25).

The Wall Street Journal's Risk & Compliance Journal: South Carolina Upgrades Medicaid System To Prepare For ACA
South Carolina is rolling out a new Medicaid platform to meet rules mandated under the Affordable Care Act that require states significantly upgrade their technology and accept more enrollees. The state is turning to an International Business Machines Corp. platform to meet the new requirements. But upgrades to social service platforms aren't without risk, as illustrated by another IBM deal to modernize a state welfare system (Schectman, 4/24).