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After failing to persuade his Legislature to expand Medicaid, Gov. Bill Walker of Alaska said Thursday that he planned to unilaterally accept the federal funds available to cover more low-income residents under the program. Mr. Walker, an independent who took office in December, said in a news conference in Anchorage that he could not wait any longer to offer health coverage to the roughly 42,000 people his administration projects will be eligible under the expansion. Expanding Medicaid — an option for every state under President Obama’s Affordable Care Act — was a campaign priority for Mr. Walker, who couched it as a “common-sense decision” for the state’s economy and for the health of its people. (Goodnough, 7/16)

The independent governor on Thursday said he had sent a letter to state legislators saying he will apply directly to Washington to extend Medicaid coverage to most residents whose incomes are up to one-third above than the poverty line in his state, and that legislators would have to call a special session or take other action to stop him. He said he was giving the state legislature 45 days to act or he would do so unilaterally after lawmakers previously declined to vote on a bill he had proposed to expand the Medicaid program, which is jointly funded and administered by federal and state governments. (Radnofsky, 7/16)

Standing in front of his whole Cabinet, Walker said he wasn’t going to wait any longer for the Legislature to act on Medicaid expansion. His administration had pushed hard for the policy during the regular session, and attempted to get the Legislature to take it up during their first special session — only to see them gavel out and gavel back in with the item removed. Walker said lawmakers had their chance. “This is the final option for me. I’ve tried everything else,” said Walker. “And one thing people have to learn about me [is] I never give up.” (Gutierrez, 7/16)

Walker is a Republican-turned-independent who was elected with support of the state Democratic Party, and Medicaid expansion was one of his key campaign promises. He made his announcement at a morning news conference in Anchorage at the headquarters of the Alaska Native Tribal Health Consortium, an organization that has backed Medicaid expansion for years. Its former director of legal and intergovernmental affairs, Valerie Davidson, is now Walker’s health and social services commissioner. She and other members of Walker’s Cabinet stood behind him as he addressed hundreds of supporters assembled in a conference room. The crowd offered cheers and rounds of applause. (Herz, 7/16)

Walker will utilize a rarely used part of state law that allows the governor to accept federal funds without the approval of the Legislature, which has the power of appropriation, while it is away from session. Through the process, Walker is required to send notification to the Legislative Budget and Audit Committee, chaired by Anchorage Republican Rep. Mike Hawker. ... “There’s a couple steps along the way, but none completely eliminate my ability to do this,” Walker said. He said the law has only been used seven times previously. Hawker, a supporter of Medicaid expansion, said it’s in everyone’s interest to sign off on the spending sooner than later and bring an end to the fight over Medicaid expansion. (Buxton, 7/17)

In Alaska, the Legislative Budget and Audit Committee has the authority to review requests for federal funds when the legislature is not in session. The committee has until Sept. 1 to vote whether or not to support the state's request for money, or to recommend a special session of the legislature to review expansion options. After Walker's announcement, the committee's chairman, Representative Mike Hawker, said the panel's role is a formality and simply influences how quickly the money is made available. (Quinn, 7/16)

Sen. Brian Shiozawa expressed confidence Thursday that the governor and key legislative leaders will come up with a Medicaid expansion plan that's even better than Healthy Utah or the House's Utah Cares plan. Shiozawa, a Cottonwood Heights Republican, sponsored the governor's Healthy Utah plan, which the governor negotiated during 2014 with the Obama administration. It passed in the Senate during the last legislative session, but failed in the House, which favored a more modest expansion called Utah Cares. Gov. Gary Herbert, Lt. Gov. Spencer Cox, House Speaker Greg Hughes, Senate President Wayne Niederhauser, Rep. Jim Dunnigan and Shiozawa have been meeting since the session, trying to craft a plan to provide health care coverage for poor Utahns. (Moulton, 7/16)

Shiozawa said he believes the process, which began at the end of the session in March, has been "very productive" thus far. ... An estimated 100,000 Utahns who fall between 100 percent and 138 percent of the federal poverty level — eligible for Medicaid under an optional full expansion model presented in the Affordable Care Act — remain without health insurance, as they fall in what has been called the coverage gap. ... There is some concern that a portion of the 375,000 Utahns who also fall into that same income bracket but already have private or employer-sponsored health insurance, or the more than 115,000 who have enrolled through the federal marketplace, could potentially abandon their current coverage for less expensive or free Medicaid if and when it is offered. (Leonard, 7/16)

In demonstrations across North Carolina, healthcare advocates are continuing to call on Gov. Pat McCrory to release his plan to expand the state's Medicaid roles under the Affordable Care Act. About thirty protesters in front of the old Capitol building Thursday focused on expanding Medicaid to parents working low-income jobs. Other demonstrations pushing to expand healthcare coverage are taking place Thursday in Asheville, Charlotte, Fayetteville, Greensboro and Greenville. (7/16)

About 10,000 more private-option enrollees and other Arkansas Medicaid recipients have been notified this week that their coverage will end on July 31, raising to 25,000 the number whose coverage is set to end, the director of the state Department of Human Services said Thursday. Also on Thursday, representatives from Arkansas Blue Cross and Blue Shield told members of the state Legislature's Health Care Reform Task Force that, compared with customers enrolled in traditional private plans, private-option enrollees have been more frequent users of the emergency room and were less likely to see primary-care doctors. (Davis, 7/17)