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The State of Medicaid Expansion in the States

Updated as of March 26, 2014


Alabama
Expanding Medicaid? No
Governor: Robert Bentley (R)
Make-up of Legislature:
House: 66 Republicans, 37 Democrats, 1 Independent, 1 Vacancy
Senate: 23 Republicans, 11 Democrats, 1 Independent
2014 Legislative Session: January 14 – early April
Number of residents who newly qualify for Medicaid under expansion: 321,000
Governor Bentley publicly rejected Medicaid expansion in November, 2012, stating that The Affordable Care Act is neither affordable nor does it actually improve healthcare.” The Legislature took no action on Medicaid expansion, though a minority of members did call for expansion.


Alaska
Expanding Medicaid? No
Governor: Sean Parnell (R)
Make-up of Legislature:
House: 27 Republicans, 13 Democrats
Senate: 13 Republicans, 7 Democrats
2014 Legislative Session: January 21 – April 20
Number of residents who newly qualify for Medicaid under expansion: 41,000
Governor Parnell refused federal funding to expand the state’s Medicaid program in February, 2013. He cited concerns that the federal government would renege on its funding promises.


Arizona
Expanding Medicaid? Yes
Governor: Jan Brewer (R)
Make-up of Legislature:
House: 36 Republicans, 24 Democrats
Senate: 17 Republicans, 13 Democrats
2014 Legislative Session: January 13 – early April
Number of residents who newly qualify for Medicaid under expansion: 89,000
Governor Brewer announced her support for Medicaid expansion early in the Legislative Session. On June 13, the Legislature passed Medicaid expansion despite opposition from some Republican legislative leaders. Governor Brewer signed Medicaid expansion into law on June 17, 2013.


Arkansas
Expanding Medicaid? Yes, private insurance alternative
Governor: Mike Beebe (D)
Make-up of Legislature:
House: 51 Republicans, 48 Democrats
Senate: 21 Republicans, 14 Democrats
2014 Legislative Session: February 10 – March 19
Number of residents who newly qualify for Medicaid under expansion: 218,000
The Arkansas Legislature worked with Governor Beebe to create a private insurance alternative to Medicaid expansion, which passed in mid-April. The law will utilize the available federal funds to allow the state to purchase private insurance for low-income people through a health insurance exchange.


California
Expanding Medicaid? Yes
Governor: Jerry Brown (D)
Make-up of Legislature:
Assembly: 25 Republicans, 54 Democrats
Senate: 11 Republicans, 27 Democrats
2014 Legislative Session: January 6 – November 30
Number of residents who newly qualify for Medicaid under expansion: 1,873,000
California was an early proponent of Medicaid expansion and began expanding the Medicaid program soon after the Affordable Care Act was signed into law. However, Governor Brown and the Legislature disagreed over the details. On June 15, 2013, the Legislature officially passed Medicaid expansion and legislation that will reduce state funding to counties to provide indigent care. They also included a provision that allows for lawmakers to reconsider Medicaid expansion if the federal government drops below 70 percent matching funds.


Colorado
Expanding Medicaid? Yes
Governor: John Hickenlooper (D)
Make-up of Legislature:
House: 13 Republicans, 7 Democrats
Senate: 8 Republicans, 11 Democrats
2014 Legislative Session: January 8 – May 7
Number of residents who newly qualify for Medicaid under expansion: 225,000
Governor Hickenlooper proposed a Medicaid expansion plan on January 3, 2013. Medicaid expansion legislation passed both the Senate and House. The Governor signed Medicaid expansion into law on May 13, 2013.


Connecticut
Expanding Medicaid? Yes
Governor: Dan Malloy (D)
Make-up of Legislature:
House: 52 Republicans, 98 Democrats, 1 Vacancy
Senate: 14 Republicans, 22 Democrats
2014 Legislative Session: February 5 – May 7
Number of residents who newly qualify for Medicaid under expansion: 88,000
Connecticut became the first state in the nation to expand Medicaid coverage to persons at 133 percent of the Federal Poverty Level (FPL) and below. The federal government approved the state’s plan on June 21, 2010.


Delaware
Expanding Medicaid? Yes
Governor: Jack Markell (D)
Make-up of Legislature:
House: 15 Republicans, 26 Democrats
Senate: 8 Republicans, 13 Democrats
2014 Legislative Session: January 14 – June 30
Number of residents who newly qualify for Medicaid under expansion: 9,000
Delaware opted to expand Medicaid long before the Affordable Care Act was even proposed. The state expanded its program in 1996, but Governor Markell is taking advantage of the new federal funding offered through Medicaid expansion to pay for some of the costs of the states current program. Currently Delaware offers coverage up to 100 percent FPL for childless adults. With Medicaid expansion, coverage will expand to 133 percent FPL for childless adults.


District of Columbia
Expanding Medicaid? Yes
Mayor: Vincent C. Gray (D)
Make-up of City Council: 0 Republicans, 11 Democrats, 2 Independents
Number of residents who newly qualify for Medicaid under expansion: 17,000
Washington D.C. opted to expand its Medicaid program soon after the Affordable Care Act was passed, in August 2010. Mayor Gray reiterated the District ‘s decision to continue its Medicaid expansion plans in June 2012 after the Supreme Court ruled that each state could decide if it wanted to expand its Medicaid program.


Florida
Expanding Medicaid? No
Governor: Rick Scott (R)
Make-up of Legislature:
House: 75 Republicans, 44 Democrats, 1 Vacant
Senate: 26 Republicans, 14 Democrats
2014 Legislative Session: March 4 – May 2
Number of residents who newly qualify for Medicaid under expansion: 1,295,000
Governor Rick Scott opposed Medicaid expansion early on, but came out in support of the measure on February 20. State Senator Joe Negron drafted a bill to expand health care coverage by offering private insurance coverage to Floridians at or below 138 percent of the Federal Poverty Level, which passed the Senate 39-1 but failed in the House.


Georgia
Expanding Medicaid? No
Governor: Nathan Deal (R)
Make-up of Legislature:
House: 119 Republicans, 60 Democrats, 1 Independent
Senate: 38 Republicans, 18 Democrats
2014 Legislative Session: January 13 – March 20
Number of residents who newly qualify for Medicaid under expansion: 684,000
Governor Nathan Deal came out against Medicaid expansion early in the legislative session, saying that expansion would be too costly for the state. Though two smaller hospital organizations came out in favor of Medicaid expansion, the Georgia Hospital Association remained neutral on the issue – a stark contrast from Hospital Associations in almost every other state. In late May, Governor Deal announced that his administration will study how other states expand their Medicaid programs in case an alternative emerges.


Hawaii
Expanding Medicaid? Yes
Governor: Neil Abercrombie (D)
Make-up of Legislature:
House: 7 Republicans, 44 Democrats
Senate: 1 Republicans, 24 Democrats
2014 Legislative Session: Jan 15 – early May
Number of residents who newly qualify for Medicaid under expansion: 37,000
The State of Hawaii’s Medicaid program already offers coverage to adults up to 133 percent of the Federal Poverty Level, but in 2014 a new feature will be the elimination of asset tests for these non-disabled adults under the age of 65.


Idaho
Expanding Medicaid? No
Governor: Butch Otter (R)
Make-up of Legislature:
House: 57 Republicans, 13 Democrats
Senate: 28 Republicans, 7 Democrats
2014 Legislative Session: Jan 6 – March 20
Number of residents who newly qualify for Medicaid under expansion: 108,000
Governor Otter appointed a 15-member working group to study Medicaid expansion, which unanimously issued its support for expansion in November 2012. Despite the working group’s recommendation, Governor Otter came out against Medicaid expansion in his State of the State address on January 7, 2013. In March, the House Health and Welfare Committee introduced a Medicaid expansion proposal, but the proposal did not gain traction.


Illinois
Expanding Medicaid? Yes
Governor: Pat Quinn (D)
Make-up of Legislature:
House: 47 Republicans, 71 Democrats
Senate: 19 Republicans, 40 Democrats
2014 Legislative Session: January 29 – May 31
Number of residents who newly qualify for Medicaid under expansion: 522,000
Governor Quinn announced that Illinois would move forward with Medicaid expansion in July of 2012, soon after the Supreme Court ruled that states could choose whether or not they would take part in expanding their Medicaid programs. After some debate, the Legislature passed Medicaid expansion legislation in late May and Gov. Quinn signed the expansion into law on July 22, 2013.


Indiana
Expanding Medicaid? Undecided
Governor: Mike Pence (R)
Make-up of Legislature:
House: 69 Republicans, 31 Democrats
Senate: 37 Republicans, 13 Democrats
2014 Legislative Session: January 6 – March 13
Number of residents who newly qualify for Medicaid under expansion: 374,000
In January 2013, Indiana swore in a new Governor, Mike Pence, who stated early in his tenure that he would not rule out Medicaid expansion and felt that the Legislature should have a conversation about expansion. As the session continued, Governor Pence announced that his support depended on the federal government’s willingness to allow Indiana Medicaid expansion to use the current Healthy Indiana Plan to cover new enrollees. Though the Legislature did not pass any Medicaid expansion legislation in the 2013 session, they did issue a directive in 2011 that allows for the Governor to negotiate with the federal government to alter the Healthy Indiana Plan to “allow Indiana to use the plan to cover individuals eligible for Medicaid resulting from passage of the Patient Protection and Affordable Care Act.” In September 2013, the federal government granted Governor Pence a one year extension of the Healthy Indiana Plan, allowing people up to 100 percent of the federal poverty level to be covered by the Healthy Indiana Plan. Indiana has not made any decision regarding HIP or Medicaid expansion beyond 2014.


Iowa
Expanding Medicaid? Yes, private insurance alternative
Governor: Terry Branstad (R)
Make-up of Legislature:
House: 53 Republicans, 47 Democrats
Senate: 24 Republicans, 26 Democrats
2014 Legislative Session: January 13 – April 22
Number of residents who newly qualify for Medicaid under expansion: 106,000
Governor Branstad voiced his opposition to Medicaid expansion early on, but as the Legislature worked on the issue he developed his own alternative proposal, which he introduced in March. His proposal created a new program, the Healthy Iowa Plan, which would be available to low income Iowans on a sliding scale basis. In late May, Governor Branstad and Legislators came to an agreement on Medicaid expansion. The agreement creates a program called the Iowa Health and Wellness Plan, which will offer Iowa residents below 100 percent of the Federal Poverty Level (FPL) the same benefits as state employees, with the premiums paid for entirely by federal Medicaid dollars. Residents between 100 and 138 percent FPL will receive insurance through the exchanges, and their premiums will be paid for by federal Medicaid dollars. The federal government approved much of the plan, but did not allow the state to charge premiums for people who earn less than the federal poverty level.


Kansas
Expanding Medicaid? No
Governor: Sam Brownback (R)
Make-up of Legislature:
House: 90 Republicans, 35 Democrats
Senate: 32 Republicans, 8 Democrats
2014 Legislative Session: January 13 – mid May
Number of residents who newly qualify for Medicaid under expansion: 141,000
Governor Brownback never publicly offered his support or opposition to Medicaid expansion in Kansas, citing both the need for affordable health care and the cost to the State. Senate President Susan Wagle supported an amendment that would have required legislative approval to expand Kansas Medicaid, indicating that she was skeptical about Medicaid expansion but was interested in the creative negotiations other states were having with the federal government to expand the program. Despite legislative discussion, the session ended with no movement on Medicaid expansion. There is some talk of beginning the expansion conversation when the Legislature meets again.


Kentucky
Expanding Medicaid? Yes
Governor: Steve Beshear (D)
Make-up of Legislature:
House: 45 Republicans, 54 Democrats
Senate: 23 Republicans, 14 Democrats, 1 Independent
2014 Legislative Session: January 7 – April 15
Number of residents who newly qualify for Medicaid under expansion: 288,000
Governor Beshear announced his support for Medicaid expansion in early May. Though there were efforts in the Legislature to require Legislative approval of the Governor’s decision, the bills did not pass, and thus the Governor’s decision stands. The Legislature is now holding hearings on how to implement the expansion.


Louisiana
Expanding Medicaid? No
Governor: Bobby Jindal (R)
Make-up of Legislature:
House: 58 Republicans, 45 Democrats, 2 Independents
Senate: 25 Republicans, 14 Democrats
2014 Legislative Session: March 10 – June 2
Number of residents who newly qualify for Medicaid under expansion: 330,000
Governor Jindal announced his opposition to Medicaid expansion soon after the June 2012 Supreme Court decision that allowed for each state to decide whether or not it would expand its Medicaid program. Though there were legislative efforts to expand the program, they failed in both the House and Senate.


Maine
Expanding Medicaid? No
Governor: Paul LePage (R)
Make-up of Legislature:
House: 58 Republicans, 89 Democrats, 4 Independents
Senate: 15 Republicans, 19 Democrats, 1 Independent
2014 Legislative Session: January 8 – April 16
Number of residents who newly qualify for Medicaid under expansion: 46,000
Governor LePage announced his opposition to Medicaid expansion in November 2012. In March, Governor LePage began conversing with the federal government about possible options for Medicaid expansion after several Legislative Republicans announced their support for expansion. Citing Maine’s already generous Medicaid program, which covers parents up to 133 percent of the Federal Poverty Level (FPL) and childless adults up to 100 percent FPL, Governor LePage asked the federal government to cover 100 percent of the cost of expansion for 10 years instead of the three years afforded in the Affordable Care Act. Thus far, the federal government has not agreed to Governor LePage’s request. The Legislature has now passed Medicaid expansion twice, two votes short of a veto proof majority. Governor LePage has vetoed the expansion both times the bill has reached his desk. Emergency legislation to expand Medicaid will be introduced in January 2014 when the Legislature returns.


Maryland
Expanding Medicaid? Yes
Governor: Martin O’Malley (D)
Make-up of Legislature:
House: 43 Republicans, 97 Democrats
Senate: 12 Republicans, 35 Democrats
2014 Legislative Session: January 8 – April 16
Number of residents who newly qualify for Medicaid under expansion: 167,000
Governor O’Malley was an early proponent of Medicaid expansion. He signed legislation passed by both Legislative Chambers in mid-April.


Massachusetts
Expanding Medicaid? Yes
Governor: Deval Patrick (D)
Make-up of Legislature:
House: 30 Republicans, 128 Democrats, 1 Vacant
Senate: 4 Republicans, 35 Democrats, 1 Vacant
2014 Legislative Session: January 1 – December 31, 2014
Number of residents who newly qualify for Medicaid under expansion: 88,000
Because Massachusetts has had expanded coverage in place since 2006, which allows for limited coverage for parents and childless adults up to 300 percent of the Federal Poverty Level, Medicaid expansion will actually save the state money. Legislation has been signed into law and Massachusetts is moving forward with Medicaid expansion.


Michigan
Expanding Medicaid? Yes
Governor: Rick Snyder (R)
Make-up of Legislature:
House: 59 Republicans, 50 Democrats, 1 Independent
Senate: 26 Republicans, 11 Democrats, 1 Vacant
2014 Legislative Session: January 8 – Dec 19, 2014
Number of residents who newly qualify for Medicaid under expansion: 564,000
Governor Snyder came out in favor of Medicaid expansion in February 2013. After significant debate, the legislature agreed on a Medicaid expansion bill in September. However, because of the delay in approving expansion, newly eligible Medicaid enrollees may not be able to access coverage until after January 2014.


Minnesota
Expanding Medicaid? Yes
Governor: Mark Dayton (D)
Make-up of Legislature:
House: 61 Republicans, 73 Democratic Farmer Labor
Senate: 28 Republicans, 39 Democratic Farmer Labor
2014 Legislative Session: February 25 – May 19
Number of residents who newly qualify for Medicaid under expansion: 130,000
In February 2013 Governor Mark Dayton signed a Medicaid expansion bill that passed both the House and Senate. Gov. Dayton had previously expanded Medicaid in early 2011.


Mississippi
Expanding Medicaid? No
Governor: Phil Bryant (R)
Make-up of Legislature:
House: 65 Republicans, 57 Democrats
Senate: 32 Republicans, 20 Democrats
2014 Legislative Session: January 7 – April 6
Number of residents who newly qualify for Medicaid under expansion: 231,000
Governor Bryant has been opposed to Medicaid expansion since the Supreme Court ruled that each state could choose to expand their program and has been joined by Legislative Republicans in his opposition. In an effort to expand Medicaid, House Democrats blocked reauthorization of the State’s existing Medicaid program, which must be reauthorized each year by a three-fifths majority in both Chambers.  Governor Bryant called a special session so that the Legislature can reauthorize the existing Medicaid program. On June 28, the Legislature approved reauthorization of the existing Medicaid program, but did not expand Medicaid.


Missouri
Expanding Medicaid? No
Governor: Jay Nixon (D)
Make-up of Legislature:
House: 109 Republicans, 53 Democrats, 1 Vacancy
Senate: 24 Republicans, 10 Democrats
2014 Legislative Session: January 8 – May 30
Number of residents who newly qualify for Medicaid under expansion: 351,000
Governor Nixon has been a vocal supporter of Medicaid expansion, traveling around the state to rally for the expansion. The Legislature did not include Medicaid expansion in its budget. Though separate Medicaid expansion legislation was filed, it was not passed in either Chamber. Legislative leaders declared Medicaid expansion dead after the end of the Legislative session. After the session, a grassroots movement of Missourians attended several public meetings sponsored by the Speaker of the House to voice their support for Medicaid expansion, eventually resulting in the creation of three legislative interim committees charges with Medicaid “transformation.”


Montana
Expanding Medicaid? No
Governor: Steve Bullock (D)
Make-up of Legislature:
House: 61 Republicans, 39 Democrats
Senate: 29 Republicans, 21 Democrats
2014 Legislative Session: Does not meet in 2014
Number of residents who newly qualify for Medicaid under expansion: 59,000
Governor Bullock, a supporter of Medicaid expansion, included funding for the expansion in his proposed budget. House Democrats also proposed a Medicaid expansion bill, which passed the Senate but failed to be debated on the House floor by one vote. After the House vote, one House member publicly stated that he accidentally voted against debating the bill when he meant to vote for it. A coalition of organizations is now working to put an initiative on the ballot for voter approval, but the Medicaid program will not be expanded by January 2014.


Nebraska
Expanding Medicaid? No
Governor: Dave Heineman (R)
Make-up of Legislature:
Senate: Nonpartisan
2014 Legislative Session: January 8 – mid April
Number of residents who newly qualify for Medicaid under expansion: 78,000
Governor Dave Heineman opposes Medicaid expansion. The proposed bill to expand Medicaid was filibustered and lacked the votes to override the filibuster. The bill will be carried over into the next legislative session in 2014.


Nevada
Expanding Medicaid? Yes
Governor: Brian Sandoval (R)
Make-up of Legislature:
Assembly: 15 Republicans, 27 Democrats
Senate: 10 Republicans, 11 Democrats
2014 Legislative Session: Does not meet in 2014
Number of residents who newly qualify for Medicaid under expansion: 163,000
Governor Brian Sandoval was the first Republican to support Medicaid expansion.


New Hampshire
Expanding Medicaid? Yes – private alternative
Governor: Maggie Hassan (D)
Make-up of Legislature:
House: 180 Republicans, 218 Democrats, 2 Vacancies
Senate: 13 Republicans, 11 Democrats
2014 Legislative Session: January 8 – July 1
Number of residents who newly qualify for Medicaid under expansion: 51,000
Governor Hassan came out in favor of Medicaid expansion in February 2013, and acknowledged that the program could not be expanded without Legislative approval. The State Senate voted to reject funding for Medicaid expansion in early June 2013, but the House budget included funding for expansion. When the Chambers came together they agreed on a budget that sets up a committee to study the issue. The committee announced it’s support for Medicaid expansion in mid-September 2013. The Senate and House both passed a private alternative expansion plan in March 2014, and Governor Hassan signed the bill into law. The expansion plan will begin on July 1, 2014.


New Jersey
Expanding Medicaid? Yes
Governor: Chris Christie (R)
Make-up of Legislature:
Assembly: 32 Republicans, 48 Democrats
Senate: 16 Republicans, 24 Democrats
2014 Legislative Session: January 14 – December 31, 2014
Number of residents who newly qualify for Medicaid under expansion: 307,000
Governor Chris Christie, a long time opponent of the Affordable Care Act, opted to expand Medicaid, citing the financial advantages. While Medicaid will be expanded in 2014, Governor Christie vetoed a bill to make the expansion permanent, meaning it can be revisited by the Legislature and Governor in future years.


New Mexico
Expanding Medicaid? Yes
Governor: Susana Martinez (R)
Make-up of Legislature:
House: 32 Republicans, 38 Democrats
Senate: 17 Republicans, 25 Democrats
2014 Legislative Session: January 21 – February 20
Number of residents who newly qualify for Medicaid under expansion: 127,000
Governor Martinez was one of the nations first Republican Governors to come out in favor of Medicaid expansion. The state is currently moving forward with the implementation process.


New York
Expanding Medicaid? Yes
Governor: Andrew Cuomo (D)
Make-up of Legislature:
Assembly: 42 Republicans, 104 Democrats, 1 Independent, 3 Vacancies
Senate: 30 Republicans, 29 Democrats, 4 Independent Democrats
2014 Legislative Session: January 8 – December 31, 2014
Number of residents who newly qualify for Medicaid under expansion: 170,000
Governor Cuomo has been a supporter of Medicaid expansion since the Supreme Court ruled that each state had the option of whether to expand its program or not. Because the state already had high income eligibility levels (150 percent of the Federal Poverty Level (FPL) for parents and 100 percent FPL for childless adults), New York’s Medicaid expansion will not add as many people to the rolls as it will in other states. New Yorkers with the most to gain are childless adults between 100 percent FPL and 133 percent FPL.


North Carolina
Expanding Medicaid? No
Governor: Terry McAuliffe (D)
Make-up of Legislature:
House: 77 Republicans, 43 Democrats
Senate: 33 Republicans, 17 Democrats
2014 Legislative Session: May 14 – early July
Number of residents who newly qualify for Medicaid under expansion: 587,000
Governor Pat McRory signed legislation that rejects major components of the federal health care law”. He cited the inability of the state to absorb new Medicaid participants and the inefficiencies” of the current system that must be reformed before Medicaid expansion is considered. The bill to not expand Medicaid was passed through the House and Senate.


North Dakota
Expanding Medicaid? Yes
Governor: Jack Dalrymple (R)
Make-up of Legislature:
House: 71 Republicans, 23 Democrats
Senate: 33 Republicans, 14 Democrats
2014 Legislative Session: Does not meet in 2014
Number of residents who newly qualify for Medicaid under expansion: 24,000
Governor Dalrymple included funding for Medicaid expansion in his proposed budget, and the Legislature passed Medicaid expansion with relatively little difficulty. Medicaid expansion was signed into law in mid-April.


Ohio
Expanding Medicaid? Yes
Governor: John Kasich (R)
Make-up of Legislature:
House: 60 Republicans, 39 Democrats
Senate: 23 Republicans, 10 Democrats
2014 Legislative Session: January 7 – December 31, 2014
Number of residents who newly qualify for Medicaid under expansion: 578,000
Governor Kasich announced his support for Medicaid expansion in early February. After a lengthy fight with Legislative leaders, funding for Medicaid expansion was not included in the Legislature’s budget. Both Chambers created subcommittees to study the issue and create a Medicaid expansion alternative. Governor Kasich asked a legislative oversight panel called the Controlling Board to consider accepting federal funds to expand the state’s Medicaid program, and by late October the Controlling Board approved of Kasich’s plan, effectively expanding Medicaid in Ohio.


Oklahoma
Expanding Medicaid? No
Governor: Mary Fallin (R)
Make-up of Legislature:
House: 72 Republicans, 29 Democrats
Senate: 36 Republicans, 12 Democrats
2014 Legislative Session: February 3 – May 30
Number of residents who newly qualify for Medicaid under expansion: 225,000
In November 2012, Governor Mary Fallin announced that Oklahoma will not expand Medicaid because of the tremendous costs the state would have to absorb. Democratic lawmakers will look to put the issue to a vote during the next legislative session. Gov. Fallin has asked the federal government to allow the current Insure Oklahoma Plan, which is state, federally, privately funded, as an alternative to Medicaid expansion. Federal officials said that currently it is not an acceptable alternative and enrollment caps would need to be lifted to cover more people.


Oregon
Expanding Medicaid? Yes
Governor: John Kitzhaber (D)
Make-up of Legislature:
House: 26 Republicans, 34 Democrats
Senate: 14 Republicans, 16 Democrats
2014 Legislative Session: February 3 – March 7
Number of residents who newly qualify for Medicaid under expansion: 252,000
Oregon Governor John Kitzhaber proposed the expansion of Medicaid citing the increased number of people covered and the lower cost to the state. The legislation to officially approve expansion is still making its way through the legislative process, but there is little vocal opposition.


Pennsylvania
Expanding Medicaid? Undecided
Governor: Tom Corbett (R)
Make-up of Legislature:
House: 111 Republicans, 92 Democrats
Senate: 27 Republicans, 23 Democrats
2014 Legislative Session: January 7 – December 31, 2014
Number of residents who newly qualify for Medicaid under expansion: 520,000
Governor Corbett came out in opposition of Medicaid expansion in November of 2012, stating that he didn’t believe the state could absorb the cost of expanding Medicaid. In early April, the Governor announced that he might be agreeable to a compromise that would allow for federal funds to subsidize private coverage for the Medicaid expansion population. The State Senate initially included Medicaid expansion in a bill to amend the State Welfare Code, but the House stripped Medicaid expansion out of their version of the bill. A Senate Committee then accepted the House’s change, thus leaving Medicaid expansion out of the legislation. On September 16, Governor Corbett announced his plan to expand Medicaid through a private alternative. The U.S. Department of Health and Human Services has not yet approved the plan.


Rhode Island
Expanding Medicaid? Yes
Governor: Lincoln Chafee (I)
Make-up of Legislature:
House: 6 Republicans, 69 Democrats
Senate: 5 Republicans, 32 Democrats, 1 Independent
2014 Legislative Session: January 7 – early June
Number of residents who newly qualify for Medicaid under expansion: 38,000
Governor Lincoln Chafee and other state officials have been enthusiastic in their support of Medicaid expansion. The state has begun changing the current system to make the necessary structural changes to implement the ACA provisions.


South Carolina
Expanding Medicaid? No
Governor: Nikki Haley (R)
Make-up of Legislature:
House: 78 Republicans, 46 Democrats
Senate: 28 Republicans, 17 Democrats, 1 Vacancy
2014 Legislative Session: January 14 – June 5
Number of residents who newly qualify for Medicaid under expansion: 297,000
Governor Nikki Haley and Tony Keck, the Director of the Department of Health and Human Services, have actively opposed Medicaid expansion. In May 2013, the Senate voted against Medicaid expansion 23-19.


South Dakota
Expanding Medicaid? No
Governor: Dennis Daugaard (R)
Make-up of Legislature:
House: 53 Republicans, 17 Democrats
Senate: 28 Republicans, 7 Democrats
2014 Legislative Session: January 14 – March 31
Number of residents who newly qualify for Medicaid under expansion: 40,000
Governor Dennis Daugaard is opposed to expanding Medicaid at this time. He said that he would consider expanding Medicaid once he knows more information about the impact the expansion would have and the flexibility the state would have in implementing the program.


Tennessee
Expanding Medicaid? No
Governor: Bill Haslam (R)
Make-up of Legislature:
House: 70 Republicans, 28 Democrats, 1 Carter County Republican
Senate: 26 Republicans, 7 Democrats
2014 Legislative Session: January 14 – mid April
Number of residents who newly qualify for Medicaid under expansion: 361,000
After weighing his decision on Medicaid expansion for several months, Governor Haslam came out against expansion in late April. Governor Haslam offered an alternative, called the Tennessee Plan, which would use federal funds to purchase private insurance for Tennesseans who would have qualified for Medicaid expansion. Governor Haslam has not received federal approval for this plan. On August 7, Governor Haslam announced to a joint session of the Tennessee Assembly that TennCare will not be expanded at this time. In September, Governor Haslam stated, “I think one of the things about this decision on Medicaid is there’s no deadline”, leaving speculation that he may still be open to the idea of expansion. The Tennessee legislature does not reconvene until January 2014, so no changes will be made until then.


Texas
Expanding Medicaid? No
Governor: Rick Perry (R)
Make-up of Legislature:
House: 95 Republicans, 55 Democrats
Senate: 19 Republicans, 12 Democrats
2014 Legislative Session: Not meeting in 2014
Number of residents who newly qualify for Medicaid under expansion: 1,748,000
Governor Perry has held strong in his opposition to Medicaid expansion since the Supreme Court announced that states would have the option of whether or not to expand their Medicaid programs. Though a rider was included in the Senate version of the budget that would have set rules for the state to negotiate with the federal government in creating a Medicaid expansion alternative, the rider was not included in the final budget. One State Representative offered a bill that set up a private alternative to Medicaid expansion, and though it was passed out of committee, the legislature ran out of time for it to be debated and voted on in the full House. The Legislature passed a bill in late May that banned Medicaid expansion.


Utah
Expanding Medicaid? Undecided
Governor: Gary Herbert (R)
Make-up of Legislature:
House: 61 Republicans, 14 Democrats
Senate: 24 Republicans, 5 Democrats
2014 Legislative Session: January 27 – March 13
Number of residents who newly qualify for Medicaid under expansion: 105,000
Governor Herbert announced his support for a private alternative to Medicaid expansion in January 2014. He created the Healthy Utah Plan, which would use funds to purchase private insurance for low-income adults and seek a federal block grant to pay for the program. The Legislature did not pass a plan of their own during the 2014 session, so Governor Herbert is moving forward with his plan. It is unclear if the plan will be accepted by CMS.


Vermont
Expanding Medicaid? Yes
Governor: Peter Shumlin (D)
Make-up of Legislature:
House: 45 Republicans, 96 Democrats, 5 Progressives, 4 Independents
Senate: 7 Republicans, 21 Democrats, 2 Progressives
2014 Legislative Session: January 7 – mid May
Number of residents who newly qualify for Medicaid under expansion: 1,000
Vermont’s Health Care Access Commissioner, Mark Larson, announced that the state would be expanding its Medicaid program in July of 2012. Vermont already has a generous Medicaid eligibility level compared to many states, but access will be expanded to approximately one thousand adults.


Virginia
Expanding Medicaid? No
Governor: Bob McDonnell (R)
Make-up of Legislature:
House: 67 Republicans, 32 Democrats, 1 Independent
Senate: 20 Republicans, 20 Democrats
2014 Legislative Session: January 8 – March 8, Special Session convened March 24
Number of residents who newly qualify for Medicaid under expansion: 342,000
Governor McDonnell did not include Medicaid expansion in his budget amendment proposal. A bipartisan coalition of Senators approved an expedited plan for expanding the state’s Medicaid program, but House members were not so quick to approve expansion, and instead stated that any expansion should be tied to reforming the current system.


Washington
Expanding Medicaid? Yes
Governor: Jay Inslee (D)
Make-up of Legislature:
House: 42 Republicans, 55 Democrats, 1 Vacancy
Senate: 23 Republicans, 26 Democrats
2014 Legislative Session: January 13 – March 13
Number of residents who newly qualify for Medicaid under expansion: 308,000
Governor Inslee publicly supported Medicaid expansion in September 2012. The Washington legislature put considerable thought into its decision to expand the Medicaid program. Currently, the legislature is in a special session over the budget, but Medicaid expansion funds look to be included in the budget and a compromise has already been created to make both parties happy with the expansion.


West Virginia
Expanding Medicaid? Yes
Governor: Earl Ray Tomblin (D)
Make-up of Legislature:
House: 46 Republicans, 54 Democrats
Senate: 9 Republicans, 25 Democrats
2014 Legislative Session: January 8 – March 8
Number of residents who newly qualify for Medicaid under expansion: 131,000
The West Virginia Legislature included funding for Medicaid expansion in the budget they sent to Governor Tomblin in April. On May 2, Governor Tomblin announced that he would support Medicaid expansion.


Wisconsin
Expanding Medicaid? No
Governor: Scott Walker (R)
Make-up of Legislature:
Assembly: 60 Republicans, 39 Democrats
Senate: 18 Republicans, 15 Democrats
2014 Legislative Session: January 14 – December 31, 2014
Number of residents who newly qualify for Medicaid under expansion: 181,000
Governor Walker announced in February that he did not support Medicaid expansion, but that he had a plan to provide similar coverage at less cost to the state. Walker’s plan would open the Medicaid program to childless adults under 100 percent of the Federal Poverty Level, but would move many current Medicaid enrollees into the private insurance market. The Legislature’s Joint Finance Committee voted to reject Medicaid expansion in early June.


Wyoming
Expanding Medicaid? No
Governor: Matt Mead (R)
Make-up of Legislature:
House: 52 Republicans, 8 Democrats
Senate: 26 Republicans, 4 Democrats
2014 Legislative Session: February 10 – March 6
Number of residents who newly qualify for Medicaid under expansion: 24,000
Governor Mead expressed opposition to Medicaid expansion in December 2012. The Wyoming Senate rejected Medicaid expansion on January 31.

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