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Championing a program he inherited under a federal health overhaul he opposes, Gov. Asa Hutchinson has made his push to keep Arkansas' hybrid Medicaid expansion the defining issue in several Republican primary contests next month. He's also turning the election into a referendum on his first two years in office, and an indicator of how the next two will go. (DeMillo, 2/20)

[Arkansas Gov. Asa] Hutchinson said the possibility of a recession also highlights the need for states to have more flexibility to manage their Medicaid budgets. A rise in the number of people on Medicaid can be an early warning sign of a recession, the economists said. Arkansas is among the GOP-led states that have expanded Medicaid under Obama's health care overall, accepting an infusion of federal dollars. Gov. Dan Malloy of Connecticut, the chairman of the Democratic Governors Association, noted that some Republican governors took a firm stand against expanding Medicaid in their states, only to change their minds. (Nuckols, 2/20)

The Senate voted 20-10 against a budget amendment that would have expanded Medicaid for two years. It would have benefited nearly 20-thousand Wyoming low-income residents who either cannot get insurance or afford it. (Beck, 2/19)

The state Senate defeated a measure to expand Medicaid to 20,000 low-income Wyomingites on Friday afternoon, delivering the final blow to the Obamacare provision this legislative session. The amendment to the two-year state spending bill failed with 10 senators in favor of it and 20 opposed. No budget amendment appeared in the House, as lawmakers who supported Medicaid expansion said they didn’t attempt it because the opposition was even stiffer. This is the fourth consecutive year the Legislature has rejected Medicaid expansion. (Hancock, 2/20)

The Wyoming Senate voted Friday to reject expansion of the federal Medicaid program. Friday's two back-to-back votes rejecting Medicaid expansion budget amendments apparently mark the Legislature's last word on the issue this session. (Neary, 2/20)

House and Senate finance committees on Sunday unveiled dueling two-year budget proposals that reject Gov. Terry McAuliffe’s vision for Medicaid expansion but pour big money into his top priorities: education and economic development. The spending plans take different approaches to giving schools greater flexibility in how they spend tax dollars and give lawmakers and businesspeople more authority to shape the state’s approach to diversifying and growing the economy. (Portnoy, 2/21)

And neither chamber includes any budget items related to expanding Medicaid, a long-sought goal of the governor that Republicans have steadfastly opposed. McAuliffe’s spending plan assumed Virginia will expand Medicaid in the next two years, which his administration projects would save the state about $150 million in mental health, prisoner health, and indigent care costs. (Suderman, 2/21)

Calling Medicaid expansion "necessary and inevitable," Gov. Terry McAuliffe in December unveiled a new effort to provide coverage to roughly 350,000 low-income Virginians, despite continued resistance from Republicans, who control the General Assembly. A few months later, Republicans are all-but-officially closing the door on the Democratic governor's latest attempt to expand Medicaid. Neither budget proposals outlined by the Senate or the House on Sunday include any budget items related to Medicaid expansion. (2/21)

Gov. Mike Pence wants Congress to get involved in his dispute with the Obama administration over the evaluation of Indiana’s alternative Medicaid program. Pence has accused the administration of hiring an evaluator that is biased against Indiana’s approach. (Groppe, 2/20)

Idaho's lone alternative to Medicaid expansion isn't dead, but it may be on life support. The estimated $30 million plan — pitched at the beginning of the legislation session by Gov. C.L. "Butch" Otter — would provide primary and preventative care to 78,000 Idahoans who make too much to qualify for Medicaid but also don't qualify for health insurance subsidies. (Kruesi, 2/21)

The Internet allows savvy consumers to comparison shop for big ticket items. Those items may soon include medical procedures. The Florida House is ready to consider a bill (HB 1175) that would enable consumers to see what hospitals around the state charge for similar surgeries and courses of treatment. ... But Rep. Lori Berman, D-Boynton Beach, doesn’t think a database is the best way to deal with soaring health-care costs. ... She thinks the push for a database is related to the state’s refusal to accept federal dollars for Medicaid expansion. (Jordan, 2/19)