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The Biden administration is calling on Congress to expand access to home and community-based care services covered by Medicaid as part of a multi-billion dollar investment in the "care economy. "The proposal, part of a larger jobs and infrastructure plan unveiled by the White House Wednesday, asks Congress to put $400 billion toward expanding access to home and community-based care for the elderly and people with disabilities. If acted on by Congress, it would represent one of the largest financial investments made in HCBS in a decade at a time when nursing home residents have disproportionately gotten sick and died of COVID-19. (Hellmann and Christ, 3/31)

When is an offer too good to refuse? In several states, the answer is never, at least when it comes to expanding Medicaid. As part of the most recent federal stimulus, states that haven't expanded Medicaid under the Affordable Care Act can receive additional matching funds. Rather than paying 10 percent of the cost for new recipients, they’d only have to pay 5 percent over the next two years. Additional subsidies mean they would actually cost themselves money by refusing to expand. Florida, for instance, would come out ahead by $1.25 billion, even after paying its share of expanded coverage. Still, Gov. Ron DeSantis and legislative leaders remain opposed. (Greenblatt, 3/31)

Once again, the Wyoming legislature has rejected Medicaid expansion. Despite testimony providing overwhelming support for the measure and some federal aid to encourage more states to adopt the program, the Senate Labor and Health Committee voted three to two against the bill. The Wyoming Department of Health estimated that 25,000 state residents would have qualified for health insurance under the program. One of those was Cheyenne resident Marcie Kindred who told the committee that this is the only way many state residents can get health care. She said that's why so many people of different backgrounds support the bill. (Beck, 3/31)

Lawmakers have defeated similar proposals for nearly a decade. Advocates hoped this year might be different. Many House Republicans voiced a change of heart after the COVID-19 pandemic and the decline of fossil fuels rocked the state’s economy, leaving many without health coverage. This session was the first in which a bill to expand the program passed a legislative chamber. (Hughes, 3/31)

Florida hospitals are urging lawmakers to reconsider proposed Medicaid cuts that would lower hospital payments by half a billion dollars in the next fiscal year.For the 2021 to 2022 fiscal year, Florida legislators said they are seeking cuts to Medicaid to balance a shortfall caused by the COVID-19 pandemic. The state Senate's budget proposal calls for a $251 million cut to Medicaid hospital inpatient and outpatient rates, in addition to a $77 million cut in funds for hospitals that serve a disproportionate share of Medicaid patients, according to the State of Reform. (Haeffner, 3/31)

KHN: Indiana’s Medicaid Expansion — Designed By Pence And Verma — Panned In Federal Report

Indiana’s Medicaid expansion — with its “personal responsibility” provisions that require enrollees to pay monthly premiums and manage health savings accounts — proved no better at improving health and access to care than other state expansions, a federally commissioned study found. Even when compared with states that did not expand Medicaid, Indiana showed only mixed results in improving the health of low-income residents, the report said. (Galewitz, 4/1)

Gov. Ron DeSantis’ administration has quietly backed away from a policy that removed 1,730 former foster children from the state’s Medicaid rolls over the past six years in apparent violation of federal law. Since January, the Department of Children and Families has waived a state policy that required all former foster children to reapply for Medicaid when they turned age 22, even though they continued to qualify for the program until they were 26 under federal law. (Sexton, 3/31)