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A wide-ranging health care access bill penned by Republicans that includes covering hundreds of thousands of additional North Carolina adults through Medicaid received initial approval Wednesday from the state Senate. Support was nearly unanimous in the chamber for the measure, which also loosens practice restrictions on specialty nurses and eases government scrutiny of medical construction and equipment. (Robertson, 6/1)

Doctors and hospitals have spent years pushing for Medicaid expansion in North Carolina. But now that Republican leaders have proposed a bill that would do just that, some are now either lukewarm on the bill or even actively opposed. In large part, that’s because the bill also contains a number of other health care policy changes that threaten to upend other parts of the medical industry. Chip Baggett is CEO of the North Carolina Medical Society, an influential lobbying group for doctors. He said they still support Medicaid expansion, but they oppose the way the legislature is currently proposing that it happen — namely, with so many unrelated policy changes tacked on. “It’s all muddied up,” he said. (Doran, 6/1)

Republicans in the North Carolina Senate are rushing this spring to do what was once an unthinkable heresy among most GOP lawmakers in this state: Allow an additional 500,000 to 600,000 lower-income residents to enroll in the Medicaid government healthcare program. In other words: GOP Senate leaders said they will accept Medicaid expansion. This is a portion of the Affordable Care Act, aka “Obamacare,” that Republican lawmakers have nearly unanimously blocked in North Carolina since early 2013. They argued that the Medicaid expansion plan would be an expensive, unacceptable expansion of welfare. (Woolverton, 6/1)

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. (Erickson, 6/1)

KHN: Computer Glitches And Human Error Still Causing Insurance Headaches For Californians

Since California expanded health coverage under the Affordable Care Act, a large number of people have been mistakenly bounced between Covered California, the state’s marketplace for those who buy their own insurance, and Medi-Cal, the state’s Medicaid program for low-income residents. Small income changes can cause people’s eligibility to shift, but when bad information is typed into a computer system shared by the two programs — or accurate information is deleted from it — enrollees can get big headaches. (Wolfson, 6/2)

Inpatient rehabilitation providers say regulators should not change Medicare reimbursement for early transfers to home health agencies, despite the policy's potential to save the federal government close to $1 billion. In letters to the Centers for Medicare and Medicaid Services due Tuesday, providers said adding such a policy would lead to underpayments for inpatient rehabilitation care and hamper patient access to care. Home health is a continuation of inpatient rehabilitation facility care, not a replacement for it, providers argued. (Goldman, 6/1)