Medicaid expansion roundup: Where are all the states now?
Montana
In Montana, Medicaid expansion remains in limbo as state legislators decide whether to approve or deny Gov. Steve Bullock's (D) proposal. "There'll be some type of Medicaid expansion," Jim Ahrens, a lobbyist with Alliance for a Healthy Montana, told the Billings Gazette. "But conservative legislators will not pass a full government expansion." Bullock wants to expand Montana's Medicaid program through a "Healthy Montana Plan," which would use up to $750 million in federal funds to pay private insurers to administer coverage, reported the Great Falls Tribune.
Pennsylvania
Pennsylvania opened enrollment for its alternative to Medicaid expansion, which is called Healthy PA and uses private insurers to administer the plans, on Dec. 1 under outgoing Republican Gov. Tom Corbett. The state expected to cover about 900,000 residents--mostly low-income, single, working adults. But Democratic Gov.-elect Tom Wolf opposes the "complicated" alternative and wants to shift to an outright Medicaid expansion that doesn't involve private insurers. If Wolf is able to alter the Medicaid expansion plan, any individuals already enrolled won't lose their coverage.
Tennessee
Gov. Bill Haslam (R) announced an alternative to Medicaid expansion proposal in mid-December, clearing the way for the Republican-dominated state to explore Medicaid options under the ACA. However, the administration was quick to point out, "We aren't expanding Medicaid. We unveiled Insure Tennessee."
Haslam's plan to expand Medicaid in Tennessee is a two-year waiver program with two options. The plan will offer vouchers to individuals who earn about $16,100 to help them buy employer-sponsored coverage. Alternatively, eligible individuals can sign up for plans designed like health reimbursement accounts, though anyone earning above the poverty level would have to pay premiums and copays, the Washington Post reported.
Virginia
Gov. Terry McAuliffe (D) presented his budget plan to legislators in December with an eye toward expanding the state's Medicaid program. McAuliffe shared his Medicaid-alternative plan in September but quickly met opposition in Virginia's GOP-dominated House. Such strong Republican opposition to Medicaid expansion is why McAuliffe's announcement is mostly considered a symbolic move. In fact, several Democratic lawmakers seek to "create dilemmas for our Republican colleagues, especially those in targeted seats" on key issues, including continuing to push for Medicaid expansion in the state, the Roanoke Times reported.
Wyoming
Gov. Matt Mead (R) says he will push to expand the state's Medicaid program even though he was one of several state leaders to sue the Obama administration over the ACA. Mead has been talking with federal officials about a Medicaid expansion since August 2014, even though he still has concerns.
Mead has been urging the Wyoming legislature to pass a Medicaid expansion proposal that would require all Medicaid recipients to make co-payments, with higher-income members paying premiums up to $50. Although his Medicaid expansion wasn't passed in 2014, several Wyoming legislators appear to consider the issue a priority for the next session.
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