Governors eye changes to state Medicaid programs

Following the failure of the AHCA, Virginia Gov. Terry McAuliffe has introduced a budget amendment that would restore his authority to pursue planning for Medicaid expansion.

To some governors, the GOP’s decision to pull the American Health Care Act presents them with an opportunity to usher in changes to their states’ Medicaid programs, including Medicaid eligibility expansion and more conservative policies.

Such is the case in Virginia, where Democratic Gov. Terry McAuliffe has introduced a budget amendment that would restore his authority to pursue planning for Medicaid expansion.

“President Trump’s attempt to repeal the Affordable Care Act failed and even Speaker Ryan has said that Obamacare is the law of the land for the foreseeable future,” he said in an announcement. “The time has come for us to bring our taxpayer dollars back to serve the individuals who need them the most.”

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In Kansas, the state Senate gave a Medicaid expansion bill first-round approval Monday, and it plans to take a final vote today to determine whether it goes to Republican Gov. Sam Brownback. While Brownback is likely to veto the bill, just getting the measure so close to passing is a big win for its supporters, the Associated Press reported.

In North Carolina, Democratic Gov. Roy Cooper is pushing for Medicaid expansion despite opposition from the state’s GOP-controlled legislature, while in Maine, a ballot initiative will take up the issue in November, the AP added.

Some GOP governors who embraced Medicaid expansion, such as Ohio’s John Kasich, had pushed back against Congress’ proposed changes to the program that would have majorly reduced Medicaid funding.

Other states, though, are mulling different types of changes to their Medicaid programs in the wake of the AHCA’s demise. Georgia Gov. Nathan Deal, a Republican, is “exploring a variety of solutions that bring Georgians greater flexibility and access to care,” a spokeswoman told the Atlanta Journal-Constitution. That could include tweaking the “mandated minimum coverage” provisions that require Medicaid to cover a range of health services to recipients.

And in Wisconsin, Republican Gov. Scott Walker said that not only will he still not expand Medicaid, but he also wants to screen childless, able-bodied recipients of BadgerCare Medicaid coverage for drugs in a bid to get more of them off Medicaid and into the workforce, the Milwaukee Journal Sentinel reported.

New Centers for Medicare & Medicaid Services Administrator Seema Verma and Department of Health and Human Services Secretary Tom Price are both supporters of giving more states flexibility to redesign their Medicaid programs through waivers. In fact, they recently sent a letter to governors encouraging them to apply for demonstration projects such as those that put work requirements on Medicaid beneficiaries.