State Medicaid Update

Recently, several states have made or have been pursing significant changes to their state Medicaid programs. Brief summaries of some of the most significant developments can be found below:

• In Missouri, lawmakers have demonstrated resistance to Medicaid expansion despite a voter-approved referendum requiring the state to expand its program. Earlier this month, the state House of Representatives voted to redirect funding that was set aside for the expansion to other social welfare programs. Although a compromise was proposed in the state Senate to partially restore the funding, the compromise was rejected by a Senate committee.
• In Texas, the state House of Representatives recently voted down a plan that would have led to Medicaid expansion. Although recent previous efforts to pass Medicaid expansion failed in the Texas Legislature, proponents hoped this year would be different as a handful of Republicans supported the initiative. Additionally, an extension of the state’s Medicaid waiver, which helps the state reimburse hospitals for uncompensated care, was rescinded by the Biden administration on the grounds that Centers for Medicare & Medicaid Services erred in exempting the state from the normal public notice process before granting the extension.
• In Arkansas, legislators voted to keep their Medicaid expansion program for another year. Funding for the program was uncertain after the state House Representatives voted to reject the funding on several previous occasions.
• Finally, in Oklahoma, Gov. Kevin Stitt’s (R) plan to privatize the state’s Medicaid system is facing stiff opposition from the state legislature. On April 20, the state House of Representatives voted in favor of a bill that would create a managed care program run by the Oklahoma Health Care Authority instead of private companies. That bill will now be sent to the state Senate for consideration.