Politics, Funding And Policy Issues Swirl Around State Medicaid Expansion Decisions

The Texas Tribune: Feds Have New Leverage In Medicaid Showdown
If Texas wants to keep receiving billions of federal dollars to help hospitals care for uninsured patients, state lawmakers may have to look again at expanding Medicaid coverage for impoverished adults, some political observers say. That's because in 2016, Texas will have to ask the federal Centers for Medicare and Medicaid Services to renew a five-year waiver to pump $29 billion into state health care coffers. Since landing its first such waiver in 2011, Texas leaders have defiantly refused to expand Medicaid as envisioned under the Affordable Care Act, leaving more than 1 million impoverished Texans with no health insurance. (Walters, 11/11)

Deseret News: Florida Group Targets 'Healthy Utah' Medicaid Expansion Alternative
A Florida-based group is trying to stop Gov. Gary Herbert's Healthy Utah alternative to Medicaid expansion with a new website urging Utahns to sign a petition against the plan. The petition on UnhealthyUtah.com asks Herbert not to bring "D.C. values" to the state with his plan for spending the $258 million available to Utah for Medicaid expansion under the Affordable Care Act, also known as Obamacare. ... Jonathan Ingram, director of research for the Foundation for Government Accountability, incorporated in 2011 in Naples, Florida, said Utahns need to hear their case against Healthy Utah. (Roche, 11/11)

The Philadelphia Inquirer: Corbett, Wolf Could Be On Medicaid Collision Course
Gov. Corbett this summer achieved what few thought was possible: Overcoming unlikely odds, the Republican won Obama administration approval for Pennsylvania to run its own version of Medicaid expansion. With that the program to bring insurance coverage to about 600,000 people gained support from disparate interests - insurance companies, health-care providers, and advocates for the uninsured. Corbett's reelection loss last week all but doomed his signature program, "HealthyPA," just as it was about to begin. And now confusion may loom for as many as 1.4 million people - those currently enrolled in Medicaid and those uninsured but newly eligible. (Worden, 11/11)

The Wall Street Journal: Hospital CEO Contends With Medicaid Conundrum
The future of Truman Medical Centers, a two-hospital safety-net system [in Kansas City, Mo.], depends on the state legislature—and no one understands that better than its new chief executive, Charlie Shields. Mr. Shields, a genial 55-year-old, spent 20 years as a Republican lawmaker, ending up as the leader of the Missouri Senate before term limits forced him to step down. In 2010, he became chief operating officer of one of Truman’s hospitals, and in July he succeeded longtime Truman CEO John W. Bluford III. (Wilde Mathews, 11/11)

Kaiser Health News: More States Expected To Expand Medicaid In 2015
Texas and Florida, with their large uninsured populations, are not expected to offer coverage to many low-income patients. Kaiser Health News staff writers Phil Galewitz and Mary Agnes Carey discuss what you need to know before open enrollment in the health law’s marketplaces begins again on November 15th. (Carey and Galewitz, 11/12)

Meanwhile, Pennsylvania officials are planning changes to the state's Medicaid program that is not linked to expansion issues.

The Associated Press: Corbett Admin Says Medicaid Overhaul Will Simplify, Save Money
[Pennsylvania] Gov. Tom Corbett's administration is telling hundreds of thousands of adult Medicaid enrollees that their benefits will change as part of an overhaul of the medical coverage plans beginning Jan. 1. Notices were mailed last week, and adult enrollees will be sorted into one of two plans that best fit their needs, according to a spokeswoman for the Department of Public Welfare. ... The overhaul in medical plans under the traditional Medicaid program — which already insures many nursing home residents, childless adults with no income and some low-income parents — is separate from the vast, federally funded expansion of Medicaid eligibility set to take effect in Pennsylvania on Jan. 1. (Levy, 11/11)