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A legislative push in Montana to extend Obamacare health coverage to the working poor advanced on Thursday after a last-minute reprieve thanks to a procedural play by supporters, even as similar efforts in other conservative states are flagging. Some half dozen holdout states have been considering whether to join 28 states and the District of Columbia in accepting billions of federal dollars to expand Medicaid under the Affordable Care Act, President Barack Obama's program to provide healthcare to most Americans. (Stein, 4/9)

Calling it necessary to keep rural hospitals open, 13 Republicans joined House Democrats to push Medicaid Expansion through the House on Thursday. Sen. Ed Buttrey's Senate Bill 405, the HELP Act, expects to expand Medicaid coverage to an expected 45,000 people. (Inbody, 4/9)

After a hard-fought battle to get the last-standing bill to expand the Medicaid program to the floor, the Montana House of Representatives gave it an initial green light on Thursday. The House voted 54-46 to endorse the amended measure on a second reading with support from 13 Republicans and all 41 Democrats after it was sent to the floor Wednesday. (Baumann, 4/10)

One day after a lengthy floor battle to free a Medicaid expansion bill from committee, the Montana House on Thursday endorsed the measure, voting 54-46 to accept millions of federal dollars to extend subsidized health coverage to thousands of low-income Montanans. ... Thirteen Republicans and all 41 House Democrats supported the measure Thursday, setting up a final House vote later this week. If the state Senate accepts the one amendment attached Thursday by the House – a likely prospect – the bill goes to Democratic Gov. Steve Bullock for his signature. Bullock hasn’t said whether he’d sign the measure, but his top health care adviser has testified twice in favor of SB405 in hearings before legislative committees this session. (Dennison, 4/9)

Hard-line conservatives made multiple attempts to amend or kill the bill when it hit the Republican-controlled House floor Thursday, but a coalition of 13 Republicans and all 41 Democrats agreed to end debate swiftly and vote. The bill picked up two more Republican supporters in the House than it had on Wednesday. The bill previously passed the state Senate with seven Republican votes. It faces one more vote Friday, but opponents now appear outnumbered. Gov. Steve Bullock is expected to sign it. (Whitney, 4/10)

Senate Bill 405, which would expand Medicaid to cover thousands of low-income adults in Montana, is a complex, multifaceted bill. Here’s a summary of its main elements. (4/9)

Ohio Gov. John Kasich said Thursday that he's hopeful state lawmakers will approve money to support an expansion of Medicaid after fellow Republicans jettisoned the idea from his last budget. The governor's $72.3 billion, two-year spending blueprint sets aside funds to help cover the more than 500,000 low-income Ohioans who enrolled in the expanded federal-state health program. (Sanner, 4/9)

Gov. John Kasich on Thursday voiced optimism that Ohio’s year-old expansion of Medicaid under the federal health-care law will continue without again having to resort to a budgetary panel to sidestep lawmakers to draw down the funds. The governor’s $72 billion, two-year budget currently in the Ohio House anticipates continuing the coverage expansion largely to working adults even as some lawmakers don’t expect it to make the final plan that reaches his desk by June 30. “I would not anticipate [using the Ohio] Controlling Board,” Mr. Kasich said during a news conference. (Provance, 4/10)

Cell phone users, widows and widowers, college students and small businesses are the latest pawns in a showdown over Medicaid expansion in Florida. On Thursday, the Florida House is expected to overwhelmingly pass a $690 million tax cut package that could save those groups money, but only if the Senate signs off on the plan. Senate leaders say that won’t happen as long as negotiations remain stalled between the state and federal government over a $2.2 billion program that helps hospitals treat low income patients. In a compromise with the federal government, the Senate is proposing to restore those funds by expanding Medicaid, which House Republicans oppose. (Van Sickler, 4/9)

As a legislative session focused on the Kansas budget problems winds to a close with no decision on Medicaid expansion, a new study says some states that have expanded eligibility have seen their budget situations improve. The State Health Reform Assistance Network, a partnership of the Robert Wood Johnson Foundation and Princeton University, studied the effects of Medicaid expansion on budgets in eight states. (Marso, 4/9)