Payer Roundup—GOP governors up against the fence on Medicaid expansion, cuts

Republican governors, some of whom may be seeking higher office, are facing difficulties in their states regarding their Medicaid programs. (

LePage stands in defiance of required Medicaid expansion

Maine Republican Gov. Paul LePage has refused to take action on a voter-approved Medicaid expansion by its Tuesday deadline.

The state was required to submit an application to ensure about half a billion dollars in annual federal funding for expansion, according to WAGM. The governor has said he would refuse to take action until lawmakers provided funding without raising taxes, but Democrats said additional funds were not needed to file the application. Legal action by advocacy groups could follow. 

The expansion would provide coverage to an estimated 70,000 additional adults in the New England state. (WAGM)

Providers, patients push back on Florida Medicaid cuts 

A proposal to cut nearly $100 million from the Sunshine State's safety-net program is getting pushback from provider and patient advocates. 

The move, backed by the state legislature and Republican Governor Rick Scott, would reduce the grace period for retroactive Medicaid claims from three months to 30 days and could affect up to 39,000 people, according to the Safety Net Hospital Alliance of Florida. 

Proponents say the move will encourage patients to apply for the program more quickly, but opponents say it hurts the most vulnerable.

RELATED: Obama, Trump Medicaid heads agree: Expansion requests will continue despite White House's concerns

“This proposal in fact zeroes in on people with disabilities, including seniors coping with end-of-life-care," said Anne Swerlick, an attorney with the Florida Policy Institute. "They are going to be disproportionately hurt.” 

The unpopularity of the cut could spell trouble for Scott, who is widely seen as a likely contender for a U.S. Senate seat up in November that is currently held by incumbent Democrat Bill Nelson. Sabato's Crystal Ball currently rates the race a toss-up, and polling has mostly been within the single digits. (News Service of Florida)

Kasich warns possible successors of gutting Medicaid expansion

Current Ohio Governor John Kasich is warning fellow Republicans running to replace him in this year's gubernatorial election not to undercut the state's Medicaid expansion, which he has touted as a success.

“Now at some point, I will be gone and it will be very easy to cut the programs for people who need help. Don’t let it happen folks,” the two-term governor said Friday.

RELATED: States have no regrets over Medicaid expansion, Brookings analyst says

Republican gubernatorial candidate and current Lt. Governor Mary Taylor has said she plans to end the program in the state should she win in November. Her main opponent for the primary nomination, Attorney General Mike DeWine, does not have an official stance on the issue but has suggested changes to the program, including work requirements. 

A recent poll by SurveyUSA has DeWine up by double digits over Taylor. (WOSU)

Northam tries to sneak Medicaid expansion into budget, again

Democrats also have their hands full in trying to get their Medicaid agenda passed.

Virginia Democratic Governor Ralph Northam has introduced a budget proposal that includes Medicaid expansion, similar to a proposal by his predecessor Terry McAuliffe, but he may be at a standstill with one of the state's legislative bodies.

RELATED: Utah moves forward with partial Medicaid expansion but faces an uncertain future

Legislators adjourned in Richmond on March 10 without a budget deal, but it appears enough Republicans in the House of Delegates are with the chamber's minority Democrats to support including expansion in the legislation. The state senate, also narrowly controlled by Republicans, is holding out, however, according to the Richmond Times-Dispatch. 

Northam and the state's General Assembly will be working overtime to try again to pass a budget during a seven-day special session that starts April 11. (Richmond Times-Dispatch)