Health Reform WK-EDGE Will Medicaid expansion trains ever leave the station?
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Monday, January 25, 2016

Will Medicaid expansion trains ever leave the station?

By Jenny Burke, J.D., M.S.

It’s full speed ahead for Louisiana’s state Medicaid program after John Bel Edwards used an executive order to put the state Medicaid expansion plan on track, but many other state plans are being derailed. Last fall’s election bids contained many bargains to either promote expansion or dismantle it, and now that state legislatures are convening, it’s time to see which states are on which tracks. According to White House aides Shaun Donovan and Cecelia Munoz, President Obama may add some extra incentives for states to get moving on expansion.

“To help finish the job and seize these benefits in the years ahead, President Obama is proposing an extra incentive to states that have not yet expanded their Medicaid programs,” wrote Shaun Donovan, director of the White House Office of Management and Budget, and Cecilia Muñoz, assistant to the president and Director of the Domestic Policy Council, in a blog post published after the President’s State of the Union address. According to the officials, President Obama will ask Congress to include three years of full federal funding of Medicaid expansion for any state that extends eligibility for the program to most low-income residents. The actual proposal is expected to be made in the President’s fiscal 2017 budget, set to be released February 9. In the meantime, some states are attempting to move on their own.

Kentucky. Kentucky Gov. Matt Bevin (R) recently notified HHS that he plans to dismantle the state’s health insurance exchange. If it happens, Kynect will be the first successful state-run exchange to be taken down in order to join the federal enrollment site, HealthCare.gov. According to Bevin, the marketplace is redundant, but health care advocates believe that moving away from Kynect means the state will lose out on the local connection that made enrollment so successful in Kentucky. Bevin announced plans on December 30 for a “transformative” Medicaid program of his own.

Kansas. Kansas hospitals continue to push for Medicaid expansion, despite Governor Sam Brownback’s opposition. According to the Kansas Hospital Association, not expanding Medicaid has cost Kansas providers $920 million and counting. Although Brownback did not mention Medicaid expansion in his latest state of the state speech, he did state that Kansas will prevent Planned Parenthood from receiving any funds through its Medicaid program. He also requested that the newly formed Rural Health Working Group address the problems of health care delivery in rural Kansas.

Tennessee. Tennesseans have not given up on their attempt to pass Medicaid expansion. Governor Bill Haslam’s proposal to expand Medicaid, called Insure Tennessee, was defeated in the Tennessee legislature last year. He began this year by calling a special session of the legislature to reconsider the expansion program. Up for consideration is a two year pilot program which would provide health care coverage to Tennesseans who do not currently have access to health insurance or have limited options. The special session will begin Monday, February 2.

North Carolina. State officials in North Carolina had good news to share despite any official move toward Medicaid expansion, as the program is in the black for the first time. The officials also updated lawmakers on the state of Medicaid, as mandated in House Bill 372, the Medicaid reform bill that was passed through the legislature last fall. The bill calls for a newly created Division of Health Benefits to present a detailed outline of a reformed Medicaid system to the General Assembly by March 1 and complete a complicated application for federal approval by June.

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