State rejections of Medicaid expansion likely to widen health disparities

The Los Angeles Times reports that states opting against expanded eligibility -- among them, some of the nation's unhealthiest -- could fall even further behind as the Affordable Care Act is implemented. News outlets also offer reports from Arizona, Michigan, Wisconsin, Ohio, California, Florida and Virginia.

Los Angeles Times: Medicaid Opposition Underscores States' Healthcare Disparities
Republican opposition in many statehouses to expanding Medicaid next year under President Obama's healthcare law -; opposition that could leave millions of the nation's poorest residents without insurance coverage -; will likely widen the divide between the nation's healthiest and sickest states (Levey, 5/18).

The Associated Press: Brewer Wrestled With Decision On Medicaid Expansion
The weekend before Arizona Gov. Jan Brewer made her State of the State address in January, she practiced two versions of her speech: one with a Medicaid expansion and one without. The Republican governor ended up announcing during her Jan. 14 address that she wanted to expand the state's Medicaid program - known as the Arizona Health Care Cost Containment System - bucking many conservatives in her party to embrace Medicaid expansion (5/20).

Arizona Republic: Arizona Gov. Jan Brewer Staking Legacy On Medicaid
Inside a Sun City West clubhouse one recent afternoon, Republican Gov. Jan Brewer stood before fellow Republicans, many of whom she once represented as a state lawmaker or county supervisor. She was there to explain why she had bucked many conservatives in her party to embrace Medicaid expansion, a signature piece of Democratic President Barack Obama's health-care overhaul. It was a tough sell for some in this crowd -; just as it has been with many GOP state legislators, who are divided on whether to accept billions in federal funds under the Affordable Care Act to provide health coverage to tens of thousands of uninsured Arizonans (Wingett, 5/19).

Arizona Republic: Medicaid Q&A With Arizona Gov. Jan Brewer
Gov. Jan Brewer, amid the most important policy debate of her governorship, spoke with The Arizona Republic last week about why she wants to expand Medicaid in Arizona. Question: Why are you fighting so hard for Medicaid expansion? Answer: This is something I had great difficulty with -; I was such an opponent of "Obamacare." I did everything … within my power to fight it. And we lost. Elections have consequences: Obama won, and the Supreme Court upheld the health care, so it's here. Medicaid is just a small portion of Obamacare, and that's what I keep trying to tell people -; and the voters of Arizona have voted twice for expansion (Wingett Sanchez, 5/19).

CQ HealthBeat: On Medicaid: One State Moves Closer To Expansion, One Stalls
Arizona senators moved Medicaid expansion one step closer to reality in that state this week while the effort fell short in Michigan. Both states are led by Republican governors who announced earlier this year that they support expansion (Adams, 5/20).

Journal Sentinel: Taxpayers Will Pay More Under Scott Walker Health Plan, Study Says
Gov. Scott Walker's proposed rejection of a federally funded expansion of state health programs would add some $50 million in costs to state taxpayers over the next two years, according to the Legislature's nonpartisan budget office. The new report from the Legislative Fiscal Bureau immediately became part of the debate over Walker's budget proposal for Medicaid programs, which is currently before lawmakers on the Joint Finance Committee. The budget panel is rewriting Walker's bill and will send it to the Assembly and Senate early next month for their consideration (Stein, 5/17).

Sacramento Bee: Big Capitol Fight On Medi-Cal Looms Among Democrats
As he presented his revised 2013-14 budget to the Legislature last week, Gov. Jerry Brown warned against expanding spending beyond his administration's conservative revenue estimates. Citing darkening economic and revenue forecasts, Brown called on fellow Democrats in the Legislature to restrain themselves – and indirectly threatened to veto anything he considers to be too expansive (Walters, 5/20).

PolitiFact/Tampa Bay Times: Weatherford Overreaches With Claim That Medicaid Expansion Drives Deficit
The Florida House did the nation a favor by refusing to expand subsidized health insurance to 1 million low-income Floridians, argues Speaker Will Weatherford. ... Does the Medicaid expansion drastically raise the deficit? PolitiFact Florida wanted to check it out (Sanders, 5/19).

Columbus Dispatch: Medicaid Expansion Could Be On Ballot In 2014
As supporters of Medicaid expansion in Ohio grow increasingly impatient with legislative inaction, talk, both publicly and privately, is turning toward alternatives such as a 2014 ballot issue. "In the balance is health care for hundreds of thousands of Ohioans and the jobs that would be attached to those," said Anthony Caldwell, spokesman for Service Employees International Union District 1199. The SEIU is part of a broader coalition, the Ohio Alliance for Health Transformation, whose leaders still hope for legislative action before lawmakers pass the two-year budget in late June. Gov. John Kasich proposed expanding Medicaid to cover about 275,000 Ohioans who earn up to 138 percent of the federal poverty level (Siegel and Candisky, 5/18).

Richmond Times-Dispatch: Hospitals Face Anxious Period On Medicaid
Virginia hospitals face an anxious summer and fall as state lawmakers begin to take a hard look at reforming -; and potentially expanding -; the state's Medicaid program for the poor, elderly and disabled. Next month, a new legislative commission will meet for the first time to review Medicaid reforms required under the state budget that will take effect July 1. Accomplishment of those reforms will determine whether the Medicaid Innovation and Reform Commission agrees to extend the program to hundreds of thousands of uninsured Virginians -; many of whom now go to emergency rooms for care that ultimately is paid for by taxpayers (Martz, 5/19).

In related news, Kaiser Health News reports on how the Obama administration is encouraging states to streamline enrollment of adults in Medicaid -

Kaiser Health News: Feds Make It Easier For States To Enroll Poor Under Health Law
The Obama administration is making it easier for states to sign up the poor for health coverage – and to help those people stay covered. On Friday, it informed state officials that they could simplify enrollment in Medicaid, the federal-state program for the poor, to handle the onslaught of millions of anticipated enrollees next year when the health care law expands coverage. The administration said the changes are geared to states that are expanding their programs, but they may also be adopted by others (Galewitz, 5/18).