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In the climax of an exceptionally tense day, the House Ways and Means General Fund committee Tuesday approved a General Fund budget that chairman Steve Clouse, R-Ozark, said would strip $156 million from the state’s Medicaid program, a program that even the sponsor of the budget calls the “foundation” of health care in Alabama. The move came about two hours after the committee voted down a proposal to increase the cigarette tax by 25 cents a pack, a key element of House leadership’s proposal to balance the General Fund. The budget faces a $200 million shortfall. (Lyman, 8/4)

A frustrated Gov. Robert Bentley this evening sounded much like a man planning on calling legislators into a second special session even while they are struggling and mostly failing in an on-going special session to solve a looming budget crisis. "I am disappointed, very disappointed with the Legislature," Bentley said in a news conference on the south side of the Capitol shortly after a key House budget committee voted to slash $156 million from Medicaid, the state program that serves just over 1 million of Alabama's almost 5 million people, many of them poor. (Dean, 8/4)

Even as they left nearly $18 billion unspent, Texas lawmakers ordered a $350 million cut this year to Medicaid pay for therapists who perform one of health care’s most exacting jobs. In a two-year budget that was flush enough to trim taxes and triple state spending on border security, the Legislature told Medicaid officials to slash nearly a quarter of the $1.4 billion they shell out for acute care — or outpatient — therapy. The move threatens the jobs of speech, physical and occupational therapists who work with 445,000 poor Texans afflicted with, among other things, cerebral palsy, muscular dystrophy, autism and Alzheimer’s disease. (Garrett, 8/4)

Gov. Asa Hutchinson says Arkansas is suspending a push to terminate coverage for thousands on Medicaid as the state addresses a backlog of responses from recipients trying to verify their incomes. The Republican governor on Tuesday said the state won't send any more termination notices over the next two weeks. Notices have already gone out to thousands who haven't responded to efforts to verify their incomes. The state has already terminated coverage for more than 35,000 people, most of who were on Arkansas' compromise Medicaid expansion. (DeMillo, 8/4)

There's some small movement in the state Senate over two key policy differences with the House, a development that could help the North Carolina General Assembly wrap up this year's work session. Senate Rules Committee Chairman Tom Apodaca of Hendersonville on Tuesday shifted House bills on economic recruitment incentives and overhauling Medicaid from committees where they seemingly were sent to die to new committees. (8/4)