States Continue Sorting Out Choices About Health Exchanges, Medicaid Expansion

Kansas, South Dakota and Texas are among the states still making decisions -- or reconsidering old ones -- about the health law's insurance exchanges and the Medicaid expansion.

Kansas Health Institute News: ACA Opponent Says Brownback Should Reconsider Stand On Insurance Exchange
Like Kansas Gov. Sam Brownback, Bob Laszewski is a staunch opponent of the Affordable Care Act. Despite that, the Washington, D.C. consultant said at a meeting here today that Brownback is making a mistake by refusing to partner with the federal government to run the Kansas health insurance purchasing exchange that the law requires to be operational by 2014. … Brownback last year blocked Kansas Insurance Commissioner Sandy Praeger's attempts to establish a state-operated exchange, returning a $31.5 million federal grant in the process. Last month, the governor told Praeger, who also is a Republican, that he would not support her efforts to partner with the federal government to operate and fund the Kansas exchange (McLean, 12/4).

Politico Pro: South Dakota Governor: 'No' On Expansion For Now
South Dakota Gov. Dennis Daugaard says the state won't expand Medicaid for now — but he's not ruling it out for the long term. Daugaard, a Republican, included no funding for the optional expansion in his proposed budget for fiscal year 2014, which he released Tuesday. But he said in an address to the state Legislature that expansion is not "a now-or-never decision" — and left the door open for an expansion or partial expansion in the future (Smith, 12/4).

The Texas Tribune: Interactive: Comparing State Medicaid Expansions
If Texas lawmakers decide to expand Medicaid, as called for in the federal Affordable Care Act, the spending, savings, enrollment growth and reduction in the number of uninsured residents are poised to be greater in Texas than in most other states. This interactive compares the expansion of Medicaid in each state using data from a report by the Kaiser Family Foundation, a nonpartisan health care think tank (Aaronson, 12/5).

In the meantime, Health and Human Services Secretary Kathleen Sebelius will meet with state lawmakers on health law implementation Wednesday --

Politico Pro: Sebelius To Meet With State Lawmakers On ACA
State legislators are scheduled to meet with HHS Secretary Kathleen Sebelius at the department headquarters Wednesday to discuss implementation of the health care law. Sebelius asked for the meeting with the members of the National Conference of State Legislatures' Federal Health Reform Implementation Task Force, who are in town for the group's fall forum. She is scheduled to meet with the legislators for 30 minutes Wednesday afternoon. Joy Johnson Wilson, who directs health policy for NCSL, said she wants to hear Sebelius talk about state flexibility. That’s a message that governors stressed during a White House meeting with President Barack Obama on Tuesday (Millman, 12/4).

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