Va. Gov. McDonnell Sends Sebelius A Stern Message On Medicaid Expansion

Meanwhile, Iowa's governor offers an outline of his alternative expansion plan while Ohio officials continue to press federal officials for flexibility.

The Associated Press/Washington Post: McDonnell, Under Fire From GOP Right, Sends Sebelius Stern Letter On Va. Medicaid Expansion
Under fire from the conservatives in his own Republican Party, Virginia Gov. Bob McDonnell sent the Obama administration a letter Tuesday ruling out Medicaid expansion in the 10 months left in McDonnell’s four-year term. In the seven-paragraph letter, McDonnell bluntly states to U.S. Health and Human Services Secretary Kathleen Sebelius that the expansion of the federal-state health program for the poor, elderly and disabled is his prerogative, not that of a commission. He also lectures her on shortcomings he sees in the President Barack Obama's Patient Protection and Affordable Care Act (3/5).

The Washington Post: McDonnell To Feds: No Medicaid Expansion
The governor wrote the letter at a time when conservative critics are accusing him of giving ground on Medicaid expansion in order to bolster his legacy with a sweeping transportation funding plan (Vozzella, 3/5).

Richmond Times-Dispatch: McDonnell Tells U.S. That Va. Has Not Embraced Medicaid Expansion
Gov. Bob McDonnell told the Obama administration in a letter Tuesday that the state legislature’s actions regarding Medicaid are not tantamount to expansion. McDonnell, who leaves office in January, reiterated that the program must undergo significant reforms at the federal and state levels if Virginia is to expand coverage and that he is not inclined to endorse expansion on his watch (Cain, 3/6).

Des Moines Register: Branstad Outlines Alternative To Medicaid Expansion
Iowa should seek to change how poor people receive health insurance in the same kind of way the state reformed how people could qualify for welfare payments in the 1990s, Gov. Terry Branstad said Monday. The federal government wants Iowa to let about 150,000 more Iowans join Medicaid, the government health insurance program for the poor. Branstad, a Republican, instead proposed Monday that Iowa adopt a new program, the Healthy Iowa Plan, whose participants would have to pay small premiums or adopt healthful habits, such as getting regular checkups. The participants would get their care from clinics and hospitals that would be paid to keep them well instead of just providing more and more tests and treatments (Leys and Noble, 3/4).

The Associated Press: Ohio Officials Still Seek Medicaid Flexibility
Ohio continues to press the federal government for flexibility as state lawmakers review whether to expand the Medicaid program under President Barack Obama’s health care law. Greg Moody, director of the governor’s Office of Health Transformation, told reporters Tuesday he’s encouraged by discussions with the Obama administration, but he said it’s too soon to say the two sides have reached an agreement (3/5).

Stateline: Interview: A Southern Medicaid Director's Perspective On Health Care Reform
The ranks of Republican governors refusing to expand Medicaid has shrunk in recent weeks. Nationwide, 14 of the nation’s 28 Republican governors have rejected the federally funded expansion. Eight of the holdouts are in the South. Carol Steckel sides with the governors who have decided not to expand Medicaid. Newly appointed head of North Carolina’s Medicaid program, she will oversee a top-to-bottom internal overhaul. Shortly after Steckel took the job, the state’s new Republican governor, Pat McCrory, declared the Medicaid program "broken and not ready to expand" (Vestal, 3/6).

The Associated Press: Dem: Miss. Gov A 'Fool' Not To Expand Medicaid
A Democratic lawmaker said Monday that Mississippi's Republican governor is a "fool" and a "hypocrite" for opposing Medicaid expansion. Gov. Phil Bryant has said repeatedly during the past year that Mississippi, one of the poorest states in the nation, can't afford to add up to 300,000 people to the more than 640,000 who are already on the federal-state health insurance program for the needy. The state has about 3 million residents (3/5).

National Journal: The Obama Administration's Super-Expensive, Legally Dubious Medicaid Plan
The Obama administration has hit upon a creative strategy to encourage Republican politicians to expand state Medicaid under the health care law. The only trouble: The plan is costly and its legal justification tenuous. The plan was unveiled last week when Arkansas Gov. Mike Beebe, a Democrat, said his state might use Medicaid dollars to enroll new patients in the same private health plans that will be available for residents with higher incomes (Sanger-Katz, 3/6).

Bloomberg: Texas Protesters Urge Perry To Seek Medicaid Expansion For Poor
Hundreds of protesters gathered at the Texas Capitol demanding Governor Rick Perry join other Republican governors expanding Medicaid for the poor under the U.S. health-care overhaul. Enlarging the joint state-federal program would allow uninsured Texans to be treated by primary-care doctors instead of relying on emergency rooms, said Roland Goertz, a Waco physician, at the rally yesterday in Austin (Mildenberg, 3/6).

The New York Times: Anger And Kudos As Florida Governor Tacks Left
A few days after Gov. Rick Scott of Florida endorsed a Medicaid expansion, a U-turn so sharply executed that it flabbergasted his supporters, the head of a local Tea Party group typed up a "breakup note." … Mr. Scott, 60, a former health care executive who won the governorship by calling for deep budget cuts and fiercely criticizing President Obama's health care bill, has, in his third year in office, marched toward the political center, a necessity in this diverse swing state (Alvarez, 3/5).

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