States pursue tailored Medicaid expansion approaches

Many states continue to consider Medicaid expansion options that would let them tailor the program to fit their priorities and healthcare needs, Stateline reported.

No matter what approach states take, a tailored expansion won't happen quickly. In Arkansas, Iowa and Michigan--three states with federal approval to use a private option to expand Medicaid--the process took months of negotiations and several hearings. And just last week, Arkansas lawmakers rejected legislation that would continue the public-private program.

So, how much flexibility will states ask for and how much will the Obama administration accommodate those requests? Stateline highlighted states' plans for Medicaid expansion:

New Hampshire: The New Hampshire Senate agreed on a plan to expand Medicaid by covering eligible adults under the existing program, which would shift to a private option in 2016. The House will likely approve the plan and Gov. Maggie Hassan (D) is expected to sign by the end of March.

Pennsylvania: Gov. Tom Corbett (R) filed a waiver request with the federal government proposing to expand Medicaid through the private option. The proposal originally allowed insurers to pay community clinics at commercial rates, but at the last minute he changed it to Medicaid rates, FierceHealthFinance previously reported. It will take until at least January 2015 to negotiate and implement the expansion.

Tennessee: Tennessee hasn't filed a waiver request, but Gov. Bill Haslam (R) proposed an expansion plan using the private option that would require consumers to pay some of their healthcare costs, Stateline noted.

Utah: In January, Gov. Gary Herbert became the latest Republican governor to declare his support for Medicaid expansion. Although he hasn't released any details, Utah has been considering a private option. Herbert previously said he wants the expansion to cover consumers with incomes below the federal poverty line, according to Stateline.

Virginia: The Democratic-led Virginia Senate proposed a Medicaid expansion plan, including using the private option, requiring consumers pay a portion of their health costs and mandating that considers perform job searches. The Medicaid expansion proposal is strongly opposed, however, in Virginia's GOP-led House.

Indiana: Last year, Gov. Mike Pence (R) sought federal approval to expand Medicaid using an existing low-income program that uses a high-deductible health plan with a health savings account. But the plan isn't expected to receive federal approval because it requires consumers pay more costs than Medicaid rules allow, Stateline noted. The program, Indiana Care, has about 37,000 Hoosiers enrolled and more than 50,000 on waiting lists.

To learn more:
- here's the Stateline article

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