Ground Battles Continue Over States’ Medicaid Expansion

News reports from Texas, Louisiana, Iowa, Florida and Maine highlight states' continuing debates over this health law provision.

Kaiser Health News: Texas' Rio Grande Valley Presses for Medicaid Expansion
When the sun rises over the Rio Grande Valley, the cries of the urracas – black birds – perched on the tops of palm trees swell to an unavoidable cacophony. That is also the strategy, it could be said, that local officials, health care providers and frustrated Valley residents are trying to use to convince Gov. Rick Perry and state Republican lawmakers to set aside their opposition and expand Medicaid, a key provision of the federal health law (Varney, 5/21).

The Texas Tribune: House Gives Early OK To Medicaid Expansion Ban
In a surprise turn in the House on Monday evening, a bill to reform Medicaid long-term and acute care services became a vehicle for the GOP’s platform against Medicaid expansion…Leach’s amendment — which was adopted with a vote of 87 to 57 — would prohibit the Health and Human Services Commission from providing "medical assistance to any person who would not have been eligible for that assistance and for whom federal matching funds were not available" under the state’s existing criteria for medical assistance (Aaronson, 5/20).

Dallas Morning News: House OKs Requiring Legislative Input On Medicaid Expansion
The Legislature would have to approve any enlargement of Medicaid under a provision approved by the House late Monday. Medicaid expansion “is too big a decision for the future of this state to be made by one person,” said Rep. Jeff Leach, R-Plano, the provision’s author. Leach complained that unless lawmakers change existing state law, Gov. Rick Perry with one phone call could direct state social services overlord Kyle Janek to negotiate a deal with President Barack Obama’s administration on accepting federal dollars to cover about 1 million uninsured adults in Texas (Garrett, 5/20).

The Associated Press: La. Senate Budget Committee Stalls Medicaid Expansion
State senators rejected a proposal on Monday for Louisiana to offer government-subsidized health insurance to the working poor through the federal health overhaul law known as the Affordable Care Act. The 7-3 vote by the Senate Finance Committee largely fell along party lines, with all but one Republican voting against tapping into the federal Medicaid dollars available for the health coverage (Deslatte, 5/20).

New Orleans Times Picayune: Louisiana Senate Panel Kills Medicaid Expansion Measure
Legislation allowing Louisiana to use federal health overhaul dollars to expand Medicaid eligibility standards and to pay for private health insurance plans was deferred in committee Monday, effectively killing it for the remainder of the legislative session. Senate Bill 125, by Sen. Karen Carter Peterson, D-New Orleans, known as the Louisiana Health Care Independence Program, was heavily amended in committee in April to echo legislation that passed through the Arkansas Legislature. The model, known as the Arkansas plan, required the Department of Health and Hospitals to accept federal dollars under the Affordable Care Act (Kumar, 5/20).

The Associated Press: Branstad Says He's Open To Health Care Compromise
Gov. Terry Branstad said Monday he was prepared to consider accepting federal Medicaid expansion funding as part of a compromise health care plan for low-income Iowans. Branstad has opposed expanding the Medicaid program in the state, which is permitted under President Barack Obama's health care overhaul and is supported by Senate Democrats (Lucey, 5/20).

Des Moines Register: Branstad Hints He'd OK Medicaid Expansion If Federal Funding Pledges Were Secured
Gov. Terry Branstad on Monday appeared to soften his opposition to an expansion of Medicaid, a shift one leading Democrat said could help the stalemated Legislature resolve the issue. For months, the Republican governor has sternly rejected a broadening of the state-federal program that provides health care services for low-income people, arguing that the federal government can’t be trusted to uphold its promises to fund the expansion. Instead, he’s pushed a new program that relies less on federal funds but covers fewer people. But at his news conference Monday, Branstad seemed to indicate he might accept a form of Medicaid expansion if it came with "assurances" that the feds wouldn’t renege on funding commitments in years to come (Noble, 5/20).

Health News Florida: Bean: Medicaid Debate Not Over
State Sen. Aaron Bean, R-Jacksonville, says the debate over how exactly to implement the Affordable Care Act in Florida is far from over…Bean served on the committee given the task of studying implementation of the Affordable Care Act, including the option of expanding Medicaid using federal funds. The legislature also had to decide whether the state would run its own health insurance marketplace, or let the federal government do it (Watts, 5/20).

Bangor Daily News: Maine Senate Approves Bill That Links Medicaid Expansion To Hospital Debt Repayment
For the third time in a week, Democrats in the Legislature prevailed Monday on a vote to link an expansion of Medicaid eligibility in Maine to a plan to repay the state’s Medicaid debt to its 39 hospitals. After lengthy debate, the Senate voted 20-15 in favor of LD 1546, a bill that proposes repayment of Maine’s hospital debt, a restructuring of the state’s wholesale liquor contract and — after votes initiated by majority Democrats on  two legislative committees last week — an expansion of Medicaid eligibility in the state under the Affordable Care Act (Long, 5/20).