Medicaid expansion

Iowa is scrapping its Medicaid program because there has been a spike in premiums of around 20 percent and because just two insurance carriers have joined in, FierceHealthPayer's Dori Zweig reports. Enrollees are going to be moved into the traditional Medicaid expansion program or into Medicaid managed care.

Michigan is seeking a waiver from the Obama administration to expand Medicaid to another 600,000 low-income adults, the Associated Press reports. Unde the waiver request, "adults who have been enrolled for four years would have to buy private insurance through a government health exchange or pay higher copays and contribute more to health savings accounts."

The Alaska Supreme Court ruled that the state's Medicaid expansion could proceed today, Alaska Dispatch News' Tegan Hanlon reports. Governor Bill Walker expanded Medicaid over the objections of legislators, who argue they need to approve the expansion for it to be legal. The underlying lawsuit over the issue will still proceed because the court's order was about whether a temporary restraining order would go into place.

A state judge ruled Friday that Alaska Governor Bill Walker can expand Medicaid without legislative approval, Alaska Dispatch News' Nathaniel Herz reports. Legislators moved for a preliminary injunction to stop the expansion of coverage while they argue their underlying legal challenge to the legality of the executive action. Legislators argue that they must approve the expansion of Medicaid to groups whose coverage is not required under federal law.

However, the Alaska Supreme Court will hear the decision on appeal Monday.

Now that lawmakers in Alaska have voted to sue to try to block that state's expansion of Medicaid to 40,000 low-income adults, they will have to show irreparable harm will result if a preliminary injunction isn't granted against the expansion, APRN-Anchorage's Annie Feidt reports.

Legislators are arguing that the expansion needs to have their approval, that the population that would be covered by the expansion is not a mandatory group that must get health insurance coverage, and Gov. Bill Walker violated separation of powers by unilaterally authorizing the expansion.

The Associated Press' Becky Bohrer reports that the expansion would be for "people ages 19 to 64 who are not caring for dependent children, not disabled and not pregnant, and who earn up to 138 percent of the federal poverty level."

Utah will not be expanding Medicaid, The Washington Examiner's Paige Winfield Cunningham reports. Lawmakers ended their session this week without adopting an expansion.

Even though Republican Governor Gary Herbert wanted to expand health coverage for more low-income Utah residents, legislators could not reach agreement on an expansion plan, according to Cunningham: "Utah's stalemate puts it among a number of states with GOP governors who have recently tried — but failed — to get their legislatures to approve alternative Medicaid expansion plans. Those states include Tennessee, Idaho and Wyoming."

Ohio Governor John Kasich has signed a state budget that continues the expansion of Medicaid, the Associated Press reports. The plan would require about 1 million low-income Ohio residents to pay a monthly charge for Medicaid health coverage.

However, federal regulators would have to approve requiring some adults to pay into a health savings account regardless of their income: "Beneficiaries, except pregnant women, could be cut from the program if they don’t annually contribute 2 percent of their family income or $99, whichever is less."

More than 2.9 million Ohio residents are on Medicaid, making up about a quarter of the state's population.

Now that the U.S. Supreme Court has upheld the use of tax subsidies for people buying health insurance on the federal exchange in King v. Burwell, business groups are going to press Congress to modify elements of the Affordable Care Act, Hospitals & Health Networks Daily's Marty Stempniak reports: "Trade groups representing employers — such as the National Retail Federation and American Benefits Council — urged Congress to 'seize the opportunity' and address what they say are shortcomings in the law. Those include repealing the employer mandate and Cadillac tax on pricier plans, reforming reporting requirements, and upping the 30-hour work week standard for eligibility to 40 hours."

Healthcare advocates also are going to push for the expansion of Medicaid in the Republican-led states that have refused to allow for it. Dr. John Ayanian, director of the Institute for Healthcare Policy and Innovation at the University of Michigan, told Stempniak that federal regulators may allow more flexibility in Medicaid programs, which could entice more states to participate in Medicaid expansion.

MedicalResearch.com has an interview with Eric T. Roberts and Darrell Gaskin, who reported on their research finding that the Affordable Care Act's expansion of Medicaid is going to require 2,100 more primary care providers, especially in low-income areas. The good news is they think "that this need for additional providers is manageable, particularly if Congress fully funds key primary care workforce training programs, such as the National Health Service Corps."

Arkansas has decided against imposing cost-sharing on people who are receiving Medicaid coverage under the Obamacare expansion if they are below the federal poverty level, Modern Healthcare's Virgil Dickson reports.

President Obama's administration has allowed Arkansas to mandate that beneficiaries make monthly contributions to "health independence accounts" if they enrolled in private plans on the new insurance exchange. Cost-sharing will be imposed for people above the poverty line.