The Pew Charitable Trusts - State and Consumer Initiatives about

Despite Governors’ Opposition, Strong Southern Support for Medicaid Expansion

New poll shows Deep South politicians are out of step with their constituents on Medicaid expansion.

Medicaid Expansion by the Numbers

The ACA was expected to cover 32 million uninsured Americans by 2022. Six states are on the fence about expanding Medicaid.

Safety Net Hospitals Won’t Be Docked in States That Don’t Expand Medicaid

Hospitals in non-expansion states feared they would be hit with bigger federal funding cuts than those in expansion states. HHS says that won’t happen – at least for the first two years.

Obama Administration Poised to Approve Arkansas-style Medicaid Expansions

The Obama Administration is inviting states to apply for Arkansas-style Medicaid expansions in an effort to woo those balking at traditional Medicaid expansion.

Finish Line Fast Approaching on Medicaid Expansion

The Supreme Court gave states a choice: Medicaid expansion or not. It’s time to choose. Here’s where they stand now.

Small Businesses Seek Relief from ACA Penalties

Big fines for small businesses are among the possible unintended consequences of the Supreme Court’s decision to make the Medicaid expansion optional for states.

States That Skip Medicaid Expansion May Favor New Immigrants Over U.S. Citizens

The law of unintended consequences will strike states that decline to expand Medicaid.

New Health Exchanges Unlikely to End Insurance Monopolies in Some States

The new health insurance exchanges are supposed to lead to lower prices by spurring competition between carriers. But what if insurers stay away?

Lack of Competition Might Hamper Health Exchanges

The health insurance exchanges under the Affordable Care Act are supposed to give consumers a menu of coverage choices. But will insurers agree to participate?

Hospitals Lobby Hard for Medicaid Expansion

Hospitals stand to lose billions of dollars in states that don’t expand Medicaid. They won’t accept those cuts without a fight.

After Expanding Coverage, Health Care Pioneer Seeks to Tame Costs

The Affordable Care Act will extend health care coverage to almost everybody. Now states are moving on to the next frontier in health care reform: containing costs. Once again, Massachusetts is taking the lead by putting its health care industry on an annual budget and requiring all insurers and medical providers to make detailed price lists available to the public.

Ex-Felons Are About to Get Health Coverage

Health care will be available to former prisoners through Medicaid.

Expanding Medicaid with Private Insurance

Arkansas and Ohio are pursuing a “private option” for expanding Medicaid.

Interview: A Southern Medicaid Director’s Perspective on Health Care Reform

North Carolina’s Medicaid chief has been around the program long enough to know that expanding the program isn’t the only way to deliver health care to the uninsured.

Update: Health Care Exchanges

With their deadline past, 26 states have not taken steps to establish their own health care exchanges, thereby defaulting to a federally run operation in their states.

Luring Primary Care Docs into Medicaid

Fearing a shortage of primary care doctors who will take Medicaid patients after the 2014 expansion of the program, Congress has passed la temporary pay raise.

Seizing Medicaid Expansion as a Means to Reform

Alabama aims to make its Medicaid program more efficient, before expanding it. Under consideration is a regional care plan developed in Oregon.

Diving Deeper: Nebraska Governor’s Thinking on Tax Cuts, Medicaid

Few governors are in as enviable a position as Nebraska’s Dave Heineman. The Republican has one of the highest approval rates of any governor in the country, and his state has one of the lowest unemployment rates.

As Legislatures Become More Partisan, Nebraska Holds Out

LINCOLN, Nebraska — Both in law and in practice, Nebraska has the least partisan legislature in the country. To supporters, that makes it a national model. To the state’s dominant Republican Party, however, that sometimes makes it a political obstacle.

Future of Health Law Is Largely in State Hands

The Affordable Care Act is here to stay. But in order for it to be fully effective, states have to cooperate. Many of them don’t want to.

Easiest Path to Mental Health Funding May Be Medicaid Expansion

Even after mass shootings have shed light on the inadequacy of mental health services, states are unlikely to come up with much new money. But the federal government might, through Medicaid expansion.

Brewer Endorses Medicaid Expansion Under Health Overhaul

Governor Jan Brewer will push to expand Arizona’s Medicaid program after all, she has announced, surprising many who have watched her crusade against that and other key components of President Obama’s health care overhaul.

Utah’s Health Insurance Exchange in Limbo

Utah’s attempt to preserve its health insurance exchange is testing the federal government’s flexibility on a key piece of the Affordable Care Act.

Connecticut Health Agency Fights Desperation Among the Insured

The Affordable Care Act encourages states to create insurance watchdogs like Connecticut’s Office of the Healthcare Advocate.

Parity for Behavioral Health Coverage Delayed by Lack of Federal Rules

Congress passed a mental health and drug treatment parity law four years ago, but state enforcement is stymied by the Obama Administration’s failure to issue rules.

States Get More Time to Decide If They Will Run Their Own Health Insurance Exchanges

Only a few new states have opted to build and operate their own insurance exchanges. More are taking a wait and see approach.

Obama Win Means Big Health Care Decisions for States

Many Republican states would just as soon have nothing to do with the Obama health law. But they will be swept up in it nevertheless.

Elections 2012 Infographics

This collection of infographics covers the issues of the 2012 elections and the potential impact on states. The issues featured include the economy, health care, taxes, clean energy, voter ID, economic mobility and employment.

Tennessee Plan Would Help Medicaid Families Keep Health Coverage

Low-income families will have more health insurance options starting in 2014, but income fluctuations and other circumstances could switch their subsidized plans. Tennessee is one of a handful of states developing ways to help people maintain coverage and keep seeing the same doctors.

Accountable Care Explained: An Experiment in State Health Policy

The Affordable Care Act and state fiscal pressures have spawned an array of new Medicaid cost containment and quality improvement schemes. Among the most ambitious is a health care delivery system whose components are called accountable care organizations (ACOs).

Maine Seeks to Cut Medicaid Eligibility

Maine’s Tea Party governor Paul LePage thinks the Supreme Court’s landmark ruling on healthcare gives him the opportunity to tighten Medicaid eligibility.

State Health Insurance Plans Due to Feds

The U.S. Department of Health and Human Services asked states to submit their benchmark health insurance plans —or “minimum benefits” — by Monday (October 1), a major milestone in the implementation of President Obama’s health care law. Some states are expected to let the deadline pass.

Infographic: State Health Insurance Exchanges

The Affordable Care Act asks states to create health insurance exchanges to help their residents purchase coverage. Only 15 have done so. The rest risk having the federal government do the job for them.

With VP Pick, Romney Endorses Fed-State Overhaul on Food Stamps, Medicaid

By choosing Paul Ryan as his running mate, Mitt Romney has endorsed large changes in federal-state relations, particularly in dealings with food assistance and health care.

Safety Net Hospitals Imperiled by High Court Ruling

Hospitals that serve the poor thought they would be helped by the Affordable Care Act. Now it looks as if they will be hurt by it.

As States Debate Medicaid Expansion, Maine Governor Looks to Cut Rolls

Maine Governor Paul LePage appears poised for a head-on collision with the Obama Administration over the issue of Medicaid eligibility. In the wake of the U.S. Supreme Court’s health care ruling last month — the federal government cannot take away existing Medicaid funds to penalize states that refuse to expan

For Some States, Medicaid Expansion May Be a Tough Fiscal Call

GOP governors appear poised to leave federal dollars on the table.

More GOP Officials Vow to Decline Medicaid Expansion

Republican state leaders say they’d rather forfeit federal money than dip into state coffers to expand Medicaid under the Affordable Care Act.

Court Lets States Opt Out of Medicaid Expansion

Some states are worried about the cost of the health law’s expanded Medicaid coverage. Now they can choose not to participate in it.

Governor Touts Massachusetts’ Success, Stumps for Obama

Americans will decide the fate of the American Dream this November, said Massachusetts Governor Deval Patrick in a speech to a progressive legal society in Washington, D.C. Thursday.

New Federal Grants for Aging and Disability Resource Centers

The federal government is giving states another $52 million to help elders and adults with disabilities receive the long-term care they need without abandoning their homes.

GAO: State Fiscal Gap Seen Worsening as Health Care Drives Spending

State revenues are ticking up, but health care spending will drive increasing discrepancies between revenues and expenses over the short- and long-term, the Government Accountability Office predicts.

Would 'Obamacare' Demise Mean End of 'Romneycare,' Too?

TODAY'S TAKE: Legal experts are debating what would happen to Massachusetts' sweeping health insurance law if the federal legislation it inspired, the Affordable Care Act, is struck down.

Justices Consider Severability and Medicaid

On a national political scale, severability — the question of whether the health law can stand if the so-called “individual mandate” falls — is the weightier of the two issues the court will hear today. But for states, the health law’s required expansion of Medicaid to some 16 million more people is by far the top issue.

Can Congress Require Everyone to Have Health Insurance?

State plaintiffs are arguing the law’s individual mandate is unconstitutional. The Obama administration will say it is legal under the commerce clause of the U.S. Constitution.

States Ponder Creation of Health Exchanges

TODAY'S TAKE: Republicans in state government are divided over whether to set up marketplaces for individuals and employees at small companies to buy health insurance, and Democrats are taking a variety of approaches toward rolling them out.

Supreme Court Hears First Issue: Jurisdiction

On the first day of argument in the health care case, the justices will consider whether they have jurisdiction to hear a challenge to the law’s individual mandate provision before it goes into effect.

In High-Risk Insurance, Enrollment Lags and Costs Soar

HEALTH BEAT: Claims costs for the Affordable Care Act's high risk insurance programs are much higher than predicted. Enrollment remains low, but growing. Some states are running out of federal money.

GOP Governors Stall Health Insurance Exchange Plans

HEALTH BEAT: Some GOP governors are waiting to see whether the U.S. Supreme Court will uphold the national health law before they agree to build one of its cornerstones - a state-run health insurance exchange. The wait could make it difficult to meet federal deadlines.

Building a Health Insurance Marketplace One Step at a Time

Creation of a health exchange under the new federal law is a challenge for many states. But some are learning how to do it.