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Among the 30 million people still without health insurance despite gains made under the 2010 health law, there is one surprising and poorly understood group: as many as six million people who are eligible to get near-free care through Medicaid but don’t sign up. The Obama administration was closing out the latest sign-up period for coverage under the health law on Sunday, already heralding a late rush of applicants for private coverage. From here, making a bigger dent in the uninsured rate will likely hinge on Medicaid sign-ups, an area that has gotten little formal attention. (Radnofsky, 1/31)

Arkansas Gov. Asa Hutchinson is set to meet Monday with federal officials in Washington to negotiate the future of the state’s Medicaid expansion program, which leading Republicans say could be killed if it’s not changed. No state has seen its uninsured rate fall faster since the implementation of the federal health law than Arkansas, where it has fallen more than half, to 9.1 percent, from 2013 to 2015. Most of the credit goes to the state’s decision to expand eligibility for Medicaid, which has provided coverage for around 250,000 low-income Arkansans who make up to 138 percent of the federal poverty level — about $16,000 for an individual and $33,000 for a family of four. (Ramsey, 2/1)

As Indiana enters its second year of expanded Medicaid coverage created by the Affordable Care Act, hospitals around the state report it has helped patients gain needed coverage. But it’s helping hospitals, too. The amount of unpaid bills Reid Health can’t collect from patients has dropped about 40 percent. The Health and Hospital Corporation of Marion County, which runs the hospital that has had the largest amount of uncompensated care costs in the state, has seen the share of patients without insurance drop from about 35 percent to 25 percent at Eskenazi Health. That translates into about a $15 million boost for the hospital’s bottom line. (Groppe, 2/1)

Central Ohio’s nonprofit hospitals receive hundreds of millions of dollars in tax breaks each year. But the traditional justification for those exemptions is fading rapidly. For decades, caring for the poor without expectation of payment served as the primary basis for tax breaks provided to hospitals. But Ohio's Medicaid expansion has shaken that foundation, reducing the charity-care burden by nearly half in just two years, a “Dispatch” analysis found. (Suthlery, 1/31)

Democratic Gov. John Bel Edwards withdrew a key Medicaid expansion item from a legislative committee agenda Friday morning (Jan. 29), hours after the Louisiana House announced its committee members would be mostly Republicans. ... "We didn't need the approval today to continue to do what we have to do," said Edwards, reiterating the Medicaid expansion is still on track in Louisiana. The Edwards administration was planning to ask the Legislature's joint budget committee to let it hire 248 employees at the Department of Health and Hospitals to handle Medicaid expansion. ... About 75 percent of the cost of paying for the new staff would be paid by the federal government. (O'Donoghue, 1/29)

The focus on Medicaid will shift this week from the Capitol to a courtroom during an ongoing fight over expanded coverage in Alaska. ... Legislators plan to meet this week on bills aimed at curbing and containing costs within Medicaid. Meanwhile, on Thursday, a judge in Anchorage plans to hear arguments in a lawsuit challenging Walker's authority to expand Medicaid without legislative approval. (Bohrer, 1/31)

Native American health may benefit from a debate over Obamacare in South Dakota. It's not a one-to-one connection from the nation's health care reform to the unfolding crisis on reservations, but the two have become linked in the South Dakota Legislature. Lawmakers are currently considering a plan from Gov. Dennis Daugaard to expand the federal Medicaid program to about 50,000 adults without insurance. ... Tribal representatives and spokeswomen from the state's largest hospital systems say no matter what the Legislature decides, they'll likely move forward with implementing tele-health services and other contracted health care options on South Dakota’s Indian reservations. (Ferguson, 1/30)