Traditional Medicaid expansion bills are currently under consideration in Florida, Montana, and Alaska. In other states, alternative Medicaid expansions has been voted down. The Utah House on March 5 killed Gov. Gary Herbert’s (R) Healthy Utah plan in a 16-56 vote. The proposal would have covered residents earning up to 138% of the poverty line. Instead, the Utah House on Mar. 6 passed Utah Cares, an expansion plan that would use traditional Medicaid and the state’s Primary Care Network to provide limited health care to Utahans earning up to 100% of the poverty line. That bill, sponsored by House Majority Leader Jim Dunnigan (R), has been sent on to the state senate.
And in February, a Senate panel defeated Tennessee Gov. Bill Haslam’s alternative plan to expand Medicaid under the ACA. Tennessee was widely seen as the next Republican state that could expand Medicaid, with Gov. Haslam negotiating for months with the federal government for a plan that included conservative policy elements. The governor’s Insure Tennessee plan had included two coverage tracks for patients making less than 138% of the poverty level. One plan included defined contributions for beneficiaries with employer-sponsored plans to help them pay for premiums and copays. The other option would have created health savings accounts for consumers who can earn credits to pay for health care costs by engaging in healthy behaviors.
A wild card in the future of Medicaid expansions is the case of King v. Burwell before the Supreme Court, Mr. Blumstein said. Justices are weighing whether patients in states that use the federal exchange can receive federal tax credits to buy insurance or whether the credits apply only in state-run exchanges The high court heard oral arguments in the case March 4. Some states, such as North Carolina, will not consider expanding until after the court rules.
If the court rules for the plaintiffs, “there’s going to have to be a reassessment,” Mr. Blumstein said. “The Legislature and various states will have to figure out how they want to handle Medicaid expansion and whether they want to get into the business of handling an exchange. It adds a level of complexity.”
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