More states moving forward with Medicaid expansion

The number of states deciding to pursue some form of Medicaid expansion continues to grow, with Alabama, Alaska, Florida, Tennessee and Wyoming moving forward or indicating intent to pursue an alternative plan.

Virginia Governor Terry McAuliffe is also proposing expansion again even though he has failed previously to gain support from a GOP-controlled legislature. The move is seen as symbolic because it has been voted down three times and faces stiff opposition, according to the Washington Post.

In Tennessee, where hospitals are struggling and several have closed in the last year, Governor Bill Haslam announced on December 15 that he will submit a plan to bring coverage to 200,000 low-income adults.

Haslam said that his administration has been in talks with the U.S. Department of Health and Human Services in the past few weeks and that he had gotten informal approval for the state's plan, according to the New York Times.

In Alabama, Republican Governor Robert Bentley told state legislators December 11 that he would be open to expanding Medicaid in the form of a block grant, similar to a proposal submitted by Arkansas, according to the Alabama Media Group. Approximately 191,000 Alabamians are currently in the coverage gap, meaning they don’t qualify for either a federal tax subsidy for premiums or for Medicare or Medicaid.

In Alaska, incoming governor Bill Walker, who made a campaign promise to expand Medicaid, will be pursuing that goal. The state’s Republican-controlled legislature has indicated that it won't support expansion, but Walker has appointed a health commissioner, Valerie Davidson, who has pledged to find middle ground between Walker and the legislature, according to Alaska Dispatch News.

Florida, which has 760,000 residents who fall into the coverage gap, has been presented with a plan developed by a coalition of business groups and private citizens that would allow it to tap federal Medicaid expansion dollars under a new program to be known as “A Healthy Florida Works.”

“By implementing a Healthy Florida Works program, our  state  can dramatically  cut  the  costs  of  uncompensated  care,  take full  advantage  of  the  federal  funds  set  aside  for  coverage  and  improve  the  health  of  approximately  one  million low-income,  working Floridians,” says the proposal. Florida’s Republican Governor Rick Scott has said that he supports Medicaid expansion, but it has been blocked by the state’s Republican-controlled House, according to the Miami Herald.

A report released December 15 by Florida Legal Services says estimates that hospitals would lose out on millions of dollars if Medicaid is not expanded in Florida.  

In Wyoming, the Wyoming Department of Health released a plan November 26 to expand Medicaid and provide coverage for 18,000 residents, according to the Casper Star Tribune.  On December 1, Wyoming’s Republican Governor Matt Mead threw his support behind the proposal, according to the Washington Post.  

Twenty-eight states including the District of Columbia have received approval from the Centers for Medicare and Medicaid Services (CMS) to expand Medicaid since the U.S Supreme Court decision in June 2012 made expansion a state option. 

As of December 2014, four of those states have implemented a customized expansion option: Pennsylvania, Michigan, Arkansas, and Iowa. CMS is currently reviewing a waiver proposal for Indiana, while Utah has received preliminary approval for its waiver proposal.