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NC- Lawmakers: House unlikely to take up Medicaid legislation

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[MM Curator Summary]: less than a week until the session ends, and the NC house hasn’t even brought it up in committee.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


Two area state representatives doubt the state House will act on expanding Medicaid coverage during the short session of the General Assembly that is expected to end July 1.

The state Senate overwhelming voted earlier this month to expand Medicaid in the state but state Rep. Howard Hunter, D-Hertford, and Rep. Bobby Hanig, R-Currituck, both said Monday they don’t know if the House will follow suit.

The Senate voted to expand Medicaid on a bipartisan 44-2 vote with only two Republicans voting no. One of the no votes came from state Sen. Norman Sanderson, R-Pamlico.

Sanderson will represent Pasquotank, Perquimans and Chowan and five other counties in the next legislature after defeating state Sen. Bob Steinburg, R-Chowan, in the GOP primary in May for the newly configured District 1 seat. Steinburg voted for the Medicaid expansion bill.

Sanderson did not return either phone or text messages seeking comment about his vote.

The federal government would cover 90% of the cost of Medicaid expansion, with the other 10% being covered by an assessment levied on state hospitals.

If Medicaid expansion is approved it would likely cover an additional 500,000 to 600,000 people, many of them workers with one or two low-paying jobs who make incomes that hover just around the poverty line.

Republicans hold a 69-51 majority in the House and Hunter is not sure if there is enough GOP support to move the legislation forward. Democratic Gov. Roy Cooper has long favored expanding Medicaid.

Hunter favors expansion and is confident that the entire House Democratic caucus also supports the Senate bill. Hunter said having the federal government pay for 90% of the cost makes it affordable for the state. North Carolina is one of 13 states that has not expanded Medicaid.

Hunter, however, said no House committee has held hearings on the legislation since it passed June 1.

“I’m behind Medicaid expansion 100 percent,” Hunter said. “It will be a great benefit to any rural area in the state. I doubt it will be taken up (by the House) in the short session. If it hasn’t been heard in committee by now, I doubt we will hear it. I don’t think there is enough support on the Republican side.”

Hanig said he likes some parts of the Senate Medicaid bill but is opposed to other parts that he “just can’t get behind.”

“It needs work and I think those negotiations will continue this week,” Hanig said. “We are still in discussions whether to take it up in the House. Still lots of room for improvement in the bill. We feel we have another solution and we will continue those negotiations.”

Hanig did not elaborate Monday on what parts he supports and opposes, saying he did not have the legislation in front of him.

“I don’t have it in front of me and it would be hard to speak to it without having it in front of me,” Hanig said.

A spokesperson for Sentara Albemarle Medical Center said it supports Medicaid expansion saying the hospital has been advocating for expansion for many years.

“Expanding Medicaid would support our mission to improve health every day by increasing access to preventive and routine care,” said spokesperson Randi Camaiore. “It would enhance opportunities for our community members, many who are hardworking individuals like famers, veterans, clergy and service industry workers before they need of emergency care or have higher acuity health needs. Medicaid expansion can improve the health of North Carolinians by increasing early detection for cancer, heart disease and other life-threatening illnesses.”

Hunter and Hanig are also not sure if the House will take up the controversial Parents Bill of Rights legislation that passed the GOP-controlled Senate almost entirely along party lines. Hunter opposes the legislation while Hanig supports it.

Some of the language in the legislation states that gender identity and sexual orientation may not be a part of the official curriculum until after third grade.

The legislation would also establish a parent’s right to request information about what their child is being taught in school, including lessons and textbooks and other information about how their child and their school are operating.

Hanig supports the bill because he said that parents have a right to know what their children are being taught in school.

“I feel that parents know what is best for their children,” Hanig said.

The GOP-controlled Senate passed the bill 28-18 with all Republicans and one Democrat supporting the measure. Because Democratic Gov. Roy Cooper has promised to veto the measure, the GOP-controlled House would need the support of at least three Democrats to have enough votes to override a veto.

Hanig said he wasn’t sure if the House would vote on the bill in the short session while noting a lack of Democratic support so far for the legislation. He said GOP leaders may focus on other issues, including getting the state budget finalized, in the final days of the short session.

“The amount of effort it would take to get it passed and then have it vetoed just doesn’t do us any good,” Hanig said. “I believe the current sentiment is to get the budget passed. We want to concentrate on what we can get across the finish line (in the short session).”

The Senate-approved Parents Bill of Rights legislation must first pass through several House committees, including the Rules Committee of which Hunter is a member.

“It hasn’t come before us,” Hunter said. “If it comes up it will probably be a party-line vote.”

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NC Medicaid bill causes stir over changes to how hospitals compete

MM Curator summary

[MM Curator Summary]: NC hospitals want the Medicaid expansion money; they do not want more competition under relaxed CON rules.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.




The N.C. Department of Health and Human Services oversees the state’s certificate of need process for health care systems.

TBJ file photo

The North Carolina Senate passed a sweeping health care reform bill last week, and hospitals in the state have mixed feelings about it.

The wide-ranging legislation – known as House Bill 149 or Expanding Access to Healthcare – passed through the Senate nearly unanimously in a final vote Thursday that sends the package to the House. The bill would expand access to Medicaid to an estimated 500,000 North Carolinians, a move supported by the association that represents the state’s health care systems.

“North Carolina hospitals would see a reduction in uncompensated care by closing the coverage gap, which would have a particular impact on our struggling rural hospitals,” the North Carolina Healthcare Association said in a statement. “When hospitals provide care without adequate reimbursement, costs rise for everyone, including for those with insurance.”

But while the association backs this measure, it opposes changes to the state’s certificate of need (CON) law included in the bill. The CON law requires health care providers to receive approval from the state’s Department of Health and Human Services before acquiring, replacing or adding facilities and equipment – such as a new hospital or surgical center.

For instance, last year, UNC Health and Duke Health both submitted plans to add 40 acute care beds in Durham County. State regulators approved UNC’s proposal, and the health care system has since applied to further expand the project, but Duke continues to challenge the proposal.


The new UNC Rex Holly Springs Hospital

UNC Health

The association says the CON approach “right-sized healthcare resources in our state,” while controlling costs and making care accessible. But critics of the law argue that the process inflates heath care prices by limiting competition between providers.

The Senate bill reduces the number of projects that require a certificate of need. This includes removing the CON requirement for chemical dependency treatment facilities, ambulatory surgical facilities and magnetic resonance imaging (MRI) scanners.

A nonprofit called Affordable Healthcare Coalition of North Carolina says many of the reforms in the Senate bill will “increase access to new and better care.” The nonprofit describes itself as a group of businesses, organizations and individuals concerned about the increasing health care and prescription drug costs. Two members of its board of directors work for Blue Cross Blue Shield of North Carolina.

Health care systems and hospitals in the state are “deeply concerned” about modifications to the CON law, according to the statement from the N.C. Healthcare Association.

“Modifying the current CON law would hurt the stability of rural hospitals by carving out elective and outpatient procedures which are the lifeblood of community hospitals, while allowing niche medical organizations without such federal regulation to cater to commercially insured patients,” the association said in its statement.

The association is also opposed to a part of the bill that regulates telehealth. The group said the legislation would make it “harder for providers to care for patients through modern technology.”

In addition to expanding Medicaid and reforming the state’s CON regulations, the bill includes protections against surprise medical billing. The legislation would require that patients receiving care at an in-network facility be informed ahead of time if some services or staff are out of their insurance network.

The legislation would also allow advanced practice registered nurses to provide medical services without a physician to supervise their work. The Affordable Healthcare Coalition of North Carolina says the change wouldn’t allow these nurses to perform services they’re not already performing. Instead, the bill would remove a requirement that these nurses meet with a supervising physician every six months.


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South Dakota Voters Reject GOP Effort Aimed At Derailing Medicaid Expansion

MM Curator summary

[MM Curator Summary]: Legislators tried to position a ballot measure to require more clear legislative support for funding Medicaid expansion; voters shot it down 2 to 1.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.



South Dakota voters June 7, 2022 rejected a measure that would have required certain ballot … [+] initiatives like Medicaid expansion to pass with 60% support instead of a simple majority. In this July 5, 2018 photo, volunteer Allie Christianson of Omaha, sorts late-arriving signed petitions to be added to petitions in boxes, rear, in Lincoln, Neb. to get a ballot measure to expand Medicaid in Nebraska on the November general-election ballot. The measure passed that November. (AP Photo/Nati Harnik)


South Dakota voters Tuesday overwhelmingly rejected a measure that would have required certain ballot initiatives like Medicaid expansion to pass with 60% support instead of a simple majority.

The overwhelming defeat of “Constitutional Amendment C” by a 2 to 1 margin in South Dakota comes ahead of a November referendum on expanding Medicaid health insurance for the poor in the state. With 88% of precincts reporting, the measure initiated by Republicans in the South Dakota state legislature had only 32% support with nearly 68% of South Dakota voters, or more than 110,000 voting “no” compared to less than 53,000 who supported the measure.

“Today, the people of South Dakota have preserved their right to use direct democracy,” said Kelly Hall, executive director of The Fairness Project, which campaigned against Amendment C and has helped several states expand Medicaid via voter referendums since 2017.

The Fairness Project said Amendment C was merely designed to make passage of Medicaid expansion in South Dakota more difficult. This November, the Medicaid expansion question on the ballot in South Dakota can be passed with a simple majority of votes as has already happened in six other states.

“This victory will benefit tens of thousands of South Dakotans who will choose to use the ballot measure process to increase access to health care for their families and neighbors, raise wages, and more policies that improve lives,” Hall said. “We look forward to what’s next in South Dakota: an aggressive campaign to expand Medicaid in the state.”

The campaign in South Dakota is the latest momentum to expand Medicaid coverage for the poor under the Affordable Care Act. In 2020, voters in Missouri and Oklahoma approved ballot initiatives to expand Medicaid, following the lead of successful ballot initiatives in 2018 in Nebraska, Idaho and Utah. Those states, like Maine in 2017, bypassed Republican governors and legislatures to expand Medicaid by public referendum.

South Dakota remains just one of only 12 states that has yet to expand Medicaid under the Affordable Care Act.

The expansion of Medicaid benefits under the ACA has come a long way since the U.S. Supreme Court in 2012 gave states a choice in the matter. There were initially only about 20 states that sided with President Barack Obama’s effort to expand the health insurance program for poor Americans.

The 12 holdout states including South Dakota that have yet to expand Medicaid have already missed out on generous federal funding of the Medicaid expansion under the ACA. From 2014 through 2016, the ACA’s Medicaid expansion population was funded 100% with federal dollars. The federal government still picked up 90% or more of Medicaid expansion through 2020 and that was a better deal than before the ACA, when Medicaid programs were funded via a much less generous split between state and federal tax dollars.

Last year, the U.S. Congress and the Biden administration gave states a new incentive to expand Medicaid under the ACA as part of the Covid-19 relief legislation known as The American Rescue Plan Act, which President Biden signed into law.

“In addition to the 90% federal matching funds available under the ACA for the expansion population, states also can receive a 5 percentage point increase in their regular federal matching rate for 2 years after expansion takes effect,” the Kaiser Family Foundation says in a 2021 analysis. “The additional incentive applies whenever a state newly expands Medicaid and does not expire. The new incentive is available to the 12 states that have not yet adopted the expansion as well as Missouri and Oklahoma.”


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Enrollment ticking up in Missouri’s expanded Medicaid program, but rollout still rocky


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[MM Curator Summary]: About 65% of the projected enrollment for expansion is in, but long application delays are still challenging.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


Patient Stephen Leach (center) is brought into the in the emergency room by paramedic Joe Steltenpohl (right) at Christian Hospital on Wednesday, July 31, 2013. Christian Hospital has the busiest emergency department in the St. Louis area. The hospital is doubling the size of it’s emergency room and eliminating the need for the over flow rooms in the hallway with curtains for walls like the one Leach is being seen in. Photo By David Carson,

David Carson

Kurt Erickson

JEFFERSON CITY — Missouri has enrolled nearly 65% of the people it projected would qualify for an expanded Medicaid program, potentially putting the state on track to meet a goal set when voters approved the expansion two years ago.

According to the Department of Social Services, which oversees the MO HealthNet program, 178,000 people have signed up for the federally backed health insurance program for low-income Americans.

When voters approved the expansion, it was estimated that 275,000 would be eligible for the coverage.

But the rollout, which began in October, continues to be rocky.

Nearly 60,000 people are waiting for their applications to be approved and that wait time has stretched beyond the 100-day mark, said Kim Evans, director of family services at the Department of Social Services.

At a meeting of the state’s Medicaid oversight panel Wednesday, Evans said that processing times will drop to 45 days at the end of July and 30 days by the end of August. In March, waiting times were upward of 70 days.

Evans said giving workers raises and offering overtime pay and other incentives for employees who are tasked with the applications will help lower the time it takes to process an application.

“We have a lot of work ahead of us,” Evans said Wednesday.

The shorter waiting time also was good news to Sen. Jill Schupp, D-Creve Coeur, a committee member.

“I think that’s great,” Schupp said.

Before the voter approved expansion, the Medicaid program did not cover adults without children. Coverage through MO HealthNet is now available to all Missourians with incomes below 138% of the federal poverty level, or about $18,800 per year for an individual.

MO HealthNet Director Todd Richardson said the budget for the program is “positive” heading into a new fiscal year beginning July 1.

“Overall, we are very, very pleased,” Richardson told the committee. “This is certainly the best budget we’ve had since I’ve been director.”

The $10.1 billion plan, which has not yet been signed by Gov. Mike Parson, would boost nursing home reimbursement rates by $200 million, which could help boost the pay for front-line workers at the facilities.

Another $90 million was added to the budget for reimbursing medical providers.

Both of those adjustments are expected to go into effect on July 1, affecting the more than 974,000 people who are covered by the program.

The upcoming spending plan marks the first full year the state will operate under an expanded Medicaid program that was approved by voters after years of resistance from the Republican-led Legislature.

The expansion went online in October, but frustrations have mounted for applicants who are waiting to become eligible for the health care benefits.


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Missouri struggles to process Medicaid applications

[MM Curator Summary]: Missouri Medicaid eligibility workers are struggling to keep up with the added strain of Medicaid expansion applications.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.



Sebastián Martínez Valdivia



Filing an application for presumptive eligibility is the starting point in applying for Medicaid coverage.

Missourians who apply for Medicaid are now waiting nearly four months on average to get those applications processed.

Since the state implemented Medicaid expansion in October — opening the door for most Missourians making less than 138% of the federal poverty level — wait times have ballooned.

As of February, Missourians were waiting more than two and a half times the 45 days the federal government says states should take to determine if someone is eligible.

Washington University Professor Timothy McBride spoke with KBIA reporter Sebastián Martínez Valdivia about state’s predicament. McBride studies health policy, and served as chair of the oversight committee for MO HealthNet — Missouri’s Medicaid program — from 2012 until 2019.

Sebastián Martínez Valdivia: How unusual are the wait times Medicaid applicants in Missouri are facing right now?

Timothy McBride: Very unusual. In fact, I’ve been tracking this for probably almost a decade and this is the highest number of days pending I’ve ever seen. There was a time when I was chair of the Medicaid oversight committee when the number of days pending was like 90, and we thought that was pretty high then.

Martínez Valdivia: And what are the biggest factors you think are contributing to the steep increase in wait times?

McBride: Multiple factors unfortunately. I think when I looked at it there were probably 150,000 applicants in about a four month period and a lot of those came from the federal marketplace.

So if people end up applying through the marketplace and then it tells them, ‘Well you actually are eligible for Medicaid.’ Then when the applicants come in there are probably three or four problems that we’re facing at the state level. They’re short-staffed because they have a lot of turnover in the staff, and that’s probably because of pay issues and other issues. Then actually some people have been out a lot because of COVID, so that’s another problem.

Martínez Valdivia: The state says staffing turnover is a big contributor to the difficulties they’re having. You chaired the MO HealthNet oversight committee for many years: is this a new problem for the Department of Social Services?

McBride: I think it’s more acute now than it’s ever been that I’ve seen — you know, I’m not there every day but from what I’ve heard. And I think we’ve historically paid our state employees about the lowest in the country and it just hasn’t grown very much and that problem is going to perpetuate itself. And obviously that was a discussion the legislature was having too after the governor proposed raising pay. So I think it’s always been an issue and I remember hearing about it but I think it’s become more problematic now especially as we come out of the pandemic.

Martínez Valdivia: Are there any immediate changes Missouri could make to speed up the process for applicants?

McBride: Well there are several things that I think people have been proposing for a while. And I think we actually saw this week— every week the state puts out a number of how many people are enrolled in the Medicaid expansion and it went up about 18,000 this week to over 100,000 enrolled now.

So what it appears is happening is that the state is now looking at people in a couple categories including the pregnant women category and the MO Healthnet for families category, and if they are eligible for the expansion, they’re moving them over. Frankly I think that could’ve been done a long time ago, closer to October, and I’m not exactly what took so long.

So in answer to your question, I think there are well-known ways of dealing with this that other states have used that I’m not sure our state is using.
This story was originally published by St. Louis Public Radio’s colleagues at KBIA in Columbia, Missouri.


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House speaker not budging on Medicaid extension for new moms

MM Curator summary

[MM Curator Summary]: MS House Speaker Gunn refuses to endorse extending Medicaid coverage beyond two months post-delivery.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.



JACKSON, Miss. (AP) — Mississippi House Speaker Philip Gunn says he opposes efforts to revive a proposal that would let mothers keep Medicaid coverage for a year after giving birth.

“My position on the postpartum thing has not changed,” Gunn, a Republican, told reporters Tuesday at the Capitol.

Mississippi allows two months of Medicaid coverage for women after they give birth. Advocates for low-income women say expanding the government insurance coverage up to a year could improve health outcomes in a state with a high rate of maternal mortality.

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The Republican-controlled Senate voted 46-5 on Feb. 2 to pass Senate Bill 2033 to authorize a year of postpartum coverage. The bill passed the House Medicaid Committee on March 1 but died last week when Gunn and House Medicaid Committee Chairman Joey Hood chose not to bring it up for a vote before a deadline.

Republican. Lt. Gov. Delbert Hosemann said Monday that he wants to revive an effort to extend postpartum coverage, calling it “a good-faith effort to keep our babies healthy and our mothers healthy.”

Gunn told The Associated Press last week that he did not want anything that would appear to be a broader expansion of Medicaid. Mississippi is one of a dozen states that have not expanded Medicaid to working people whose jobs do not provide health insurance. The expansion is an option under the federal health overhaul signed into law by then-President Barack Obama in 2010.

About 60% of births in Mississippi in 2020 were financed by Medicaid, according to Kaiser Family Foundation, a nonprofit organization that tracks health statistics. Only Louisiana had a higher rate, at 61%.

The Mississippi State Department of Health issued a report in April 2019 about maternal mortality in the state from 2013 to 2016. A committee of physicians, nurses and others examined deaths that occurred during pregnancy or up to one year of the end of pregnancy, and it recommended expanding postpartum Medicaid coverage to a full year.

The report said that, for those years, Mississippi had 33.2 deaths per 100,000 live births, which was 1.9 times higher than the U.S. ratio of 17.3 deaths per 100,000 live births. The report also found the Black women had 51.9 deaths per 100,000 live births. The numbers for white women were 18.9 deaths per 100,000 live births.


Follow Emily Wagster Pettus on Twitter at


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NC- Cooper administration makes new pitch for Medicaid expansion

MM Curator summary

[MM Curator Summary]: NC officials are tying the PHE funding ending to the next push for Medicaid expansion.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.



North Carolina Gov. Roy Cooper has proposed a plan in which the share would be paid through an existing tax on private Medicaid plans and additional assessments on hospitals. (Robert Willett/The News & Observer via AP/File)

By Gary D. Robertson

Associated Press

RALEIGH — North Carolina Gov. Roy Cooper’s administration made perhaps its most promising pitch yet to legislators on Tuesday to expand Medicaid, with a key health regulator calling it more advantageous than ever to cover hundreds of thousands of additional low-income adults.

Addressing a House-Senate committee  created specifically to study expansion, state Medicaid director Dave Richard said a surge in traditional Medicaid enrollment during the coronavirus pandemic and a fiscal sweetener from Washington make taking the step even more appealing.

“We come to you and say that we think Medicaid expansion is a really good deal for North Carolina and that it’s a good deal for a lot of reasons,” Richard told lawmakers. “It just makes great sense to improve the health of North Carolina citizens.”

The study committee, which began meeting last month, formed as a result of budget negotiations last fall between Republican legislative leaders and the Democratic governor, a longtime expansion advocate. North Carolina is among a dozen states that haven’t expanded Medicaid under the 2010 federal health care law.

The GOP-controlled legislature would have to formally vote to permit expansion. Senate leader Phil Berger, who for years opposed expansion, is now open to it. Many House Republicans remain skeptical, and would have to be persuaded that covering an even-larger percentage of state residents with government health care is wise. GOP Rep. Donny Lambeth, a committee co-chairman, has said a package of health care access initiatives from the committee could come up for a General Assembly vote in September or October.

Other speakers Tuesday made presentations that linked expansion to increased health care industry employment and patient diagnoses and treatment, as well as improved rural communities, where uninsured rates are high.

Reducing “the coverage gap will improve the quality of life of rural North Carolinians in the communities that they call home,” said Patrick Woodie, president of the North Carolina Rural Center.

About 2.7 million North Carolina residents are now enrolled in Medicaid, the health care program for poor children and their parents and elderly low-income residents. That number has grown by over 500,000 alone since the pandemic began, in part because recipients who would be removed over time have remained on the rolls because of the COVID-19 emergency, according to Richard’s presentation.

Expansion would cover working adults and others who otherwise would make too much to qualify for traditional Medicaid. While expansion would likely benefit 600,000 residents over two years, about 200,000 people currently on Medicaid during the health emergency could qualify under an expansion, Richard said. Expanding soon would reduce paperwork needed to keep them on Medicaid, he said.

Currently, the federal government pays 73% of the state’s Medicaid costs, with the remainder coming from state tax revenues, monetary assessments on hospitals and other funds. Under the expansion plan, the federal government pays 90%.

The 2021 federal COVID-19 relief law would give North Carolina and other nonexpansion states more money to cover traditional Medicaid patients for two years if they accept expansion. Richard said that would provide $1.5 billion in additional revenues for the state.

An analyst in the General Assembly’s nonpartisan staff said Medicaid expansion would provide a fiscal net positive for state government in the first two years. In the years following, the state would have to locate an additional $500 million to $600 million annually to pay its share, analyst Mark Collins wrote.

Cooper has proposed a plan in which the share would be paid through an existing tax on private Medicaid plans and additional assessments on hospitals. Hospitals benefit from treating Medicaid patients who, without expansion, would be considered charity-care cases.

“This is a program that is financially self-sustaining,” Richard said.

Questions and comments on expansion from Republican committee members focused largely on doctor and nursing shortages the state is facing.

Members from both parties were encouraged about a report on the transition of 1.7 million Medicaid recipients to five managed care plans last summer. Peter Daniel with the North Carolina Association of Health Plans said the five are well-prepared to accept more enrollees should legislators agree to expansion.


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WY-Wyoming Medicaid expansion budget amendment ruled unconstitutional

MM Curator summary

[MM Curator Summary]: The move to approve expansion in the legislature has now failed in both the House and the Senate.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.



CHEYENNE — The full Wyoming Senate wasn’t able to vote on a Medicaid expansion amendment to the budget bill Wednesday night after the Rules Committee declared it unconstitutional.

Medicaid expansion has been a long-term effort by advocates such as Better Wyoming and the Healthy Wyoming Coalition, which made arguments in support of passing legislation so 24,000 residents could gain access to medical insurance. The groups said it also would encourage economic growth and help businesses retain employees.

Although there has been considerable support shown across the state, the Senate entertaining the amendment was one of the last opportunities for expansion promoters this year.

House Bill 20, the “Medical treatment opportunity act,” was never introduced in the House of Representatives because House Speaker Eric Barlow, R-Gillette, said there weren’t enough votes for it to meet the two-thirds threshold required for non-budget bills during a budget session.

But Sen. Cale Case, R-Lander, followed through on his intention to bring it to the Senate budget discussions. He is co-chair of the Joint Revenue Interim Committee, which sponsored HB 20.

“This expansion is pro-hospitals,” Case told fellow legislators as he introduced the amendment. “It creates jobs. It supports those very people that we care about, the people that wait on your table or clean your hotel room. These are working people. These aren’t unemployed people.”

As soon as the amendment was introduced, however, Majority Floor Leader Sen. Ogden Driskill, R-Devils Tower, asked Case to withdraw it or adhere to a Senate Rules Committee review.

The proposal was sent to the Rules Committee, where it was deemed unconstitutional by a 3-2 vote, since it wasn’t an ordinary expenditure of the Legislature.

I see nothing in here that has anything to do with appropriations,” Driskill said. “And it is a bill.”

This was one of the last budget amendments in a long line of them considered throughout the day Wednesday, spanning from education cuts to appropriations for suicide prevention.

Sen. Bill Landen, R-Casper, was successful in receiving votes for the first addition to the budget, which was $25,000 for the purpose of hosting a statewide conference on suicide by first responders, and developing a plan to address the issue.

Health care was among other major discussions. An appropriation of $3.2 million was made by the Senate for developmental disability agency providers, as well as requirements laid out for the Department of Health to submit a supplemental budget request for the fiscal year 2024 for the continued operation of the Wyoming home services care program.


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KS- Long-promised Medicaid Expansion bill introduced in Kansas legislature

MM Curator summary

[MM Curator Summary]: The KS governor facing re-election is making the normal expansion promises: “free” federal money, jobs and saving rural hospitals.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


FILE – The Kansas Statehouse stands against the sky as the sun sets in the distance Monday, April 27, 2020, in Topeka, Kan.(Charlie Riedel | AP)

TOPEKA, Kan. (WIBW) – Governor Laura Kelly is hoping to make good on her 2018 campaign promise to expand Medicaid with new legislation introduced on Wednesday.

Kansas Governor Laura Kelly says on Wednesday, Feb. 9, she announced legislation to expand Medicaid – KanCare – to provide over 150,000 Kansans with access to affordable healthcare.

Gov. Kelly said the move would also create over 23,000 new jobs to strengthen the state’s economy.

“Expanding Medicaid so that thousands of hard-working Kansans have access to affordable health care would boost the Kansas economy,” Kelly said. “Expansion would inject billions of dollars into our state, create thousands of jobs, help retain our healthcare workers in Kansas —and help rural hospitals’ bottom lines. It’s time to work together to deliver for Kansans and get this done once and for all.”

Under the proposed bill, Medicaid would expand to cover Kansans who earn up to the full 138% of the Federal Poverty Level starting on Jan. 1, 2023.

Gov. Kelly said about 90% of the expansion would be paid by the federal government.

Furthermore, Kelly said if Medicaid is expanded, Kansas is poised to get an additional $370 million over the next eight fiscal quarters for the current enrollees. She said that is a total of $68.5 million in State General Fund savings in the Fiscal Year 2023 alone, which will be reallocated for a one-time investment in housing, childcare and workforce development.

A 2022 statewide survey found 78% of Kansans support Medicaid expansion to allow for more residents to qualify for coverage.

“The list of reasons to expand Medicaid grows with every year we refuse to do so,” said Senate Democratic Leader Dinah Sykes. “This wildly popular policy will ensure we have a healthy workforce, create jobs, and attract businesses. More importantly, it will allow our fellow Kansans to flourish and participate fully in our state, which brings prosperity for all of us. The first best time to expand Medicaid was in 2014. The next best time is now.”

Kelly said this is not only the right thing to do for Kansas, but it is incredibly popular among all political parties.

“Expanding Medicaid is enormously popular among Kansas and addresses many issues facing the state. First and foremost, it is a pro-business, pro-growth policy,” said House Democratic Leader Tom Sawyer. “Throughout the legislative session, people repeatedly ask what we can do to keep our college graduates in the state and bring in outside business investment. Medicaid expansion is a clear solution with bipartisan voter support. It’s past time to embrace this common-sense policy.”

According to the Governor, expanding Medicaid in the Sunflower State would boost the economy by:

  • Providing affordable health insurance to hundreds of thousands of Kansans
  • Stimulate the economy for rural, suburban, and urban communities alike
  • Create tens of thousands of new jobs
  • Inject billions of dollars in increased economic output
  • Retain health care jobs in Kansas

The bill would require the Secretary of Health and Environment to gather data from applicants about employment history through the Medicaid application. Unemployed or underemployed Kansans will be referred to the Department of Commerce or Department of Children and Family Services to help the applicant find job opportunities.

In 2021, a Medicaid expansion amendment to SB 238, which died on general orders on May 21. A day before the bill died, Gov. Kelly vetoed SB 29 which would have provided short-term health plans because a solution to the problem fixed by the bill would have been to expand Medicaid instead.

In September she sent a letter to Congressional leadership to again urge them to pass Medicaid expansion legislation.

In January, House Democrats said they introduced a Medicaid expansion amendment to the Kansas Constitution, as well as one to legalize marijuana recreationally and medicinally. In February 2021, Kelly even proposed Medicad expansion be funded by the legalization of marijuana.

Medicaid expansion was a promise Kelly ran on in her campaign for Governor in 2018.

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SD – Senate rejects Medicaid expansion, leaving it to election

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[MM Curator Summary]: State reps voted naye on expansion by a 2 to 1 margin.


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PIERRE, S.D. (AP) — A proposal to expand Medicaid health coverage eligibility was defeated in the South Dakota Senate Tuesday, leaving the decision to voters in the November election.

Republican Sen. Wayne Steinhauer had brought a proposal to the Legislature to make Medicaid, a federal-state health insurance program for low-income people, available to people who live below 133% of the federal poverty level. That is currently about $17,000 annually for an individual or $35,000 for a family of four.

“This thing is about people,” he said in an effort to counter arguments from his fellow Republicans that it would grow the size of government and drain money from elementary and high schools.

The Republican-controlled Senate rejected his bill on a 12 to 23 vote.

But a campaign backed by South Dakota’s major health care systems is trying to get voters to pass a constitutional amendment to expand Medicaid eligibility on the November ballot.

“It’s clear that the only path to expanding Medicaid in South Dakota is by letting the people vote on it directly,” said Zach Marcus, the manager for the campaign, in a statement.

He asserted that the proposal would allow 42,500 more people to access health care coverage and bring $1.3 billion in federal money to the state.


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