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Add Tennessee and Kansas to the list of states that have been warned by the Obama administration that failing to expand Medicaid under the Affordable Care Act could jeopardize special funding to pay hospitals and doctors for treating the poor. The Centers for Medicare & Medicaid Services confirmed Tuesday that it gave officials in those states the same message delivered to Texas and Florida about the risk to funding for so-called “uncompensated care pools” — Medicaid money that helps pay the cost of care for the uninsured. (Galewitz, 4/21)

CMS has told nine states — some that remain fiercely opposed to Medicaid expansion as well as others that have implemented the Obamacare provision — that its willingness to provide billions of dollars for hospital uncompensated care pools is quickly waning. (Pradhan, 4/21)

While the 40-member Senate convened a rare emergency meeting to discuss Florida’s budget dilemma Tuesday — with more than 100 lobbyists, citizen activists and reporters attending — House Republicans took up the same issue behind closed doors. To keep reporters and members of the public out, a legislative aide was posted at the door. After the meeting, House Speaker Steve Crisafulli, R-Merritt Island, told reporters that the caucus discussed the major sticking points of this year’s legislative session: Medicaid expansion and the future of federal hospital funding known as the Low Income Pool. (McGrory, 4/21)

Blaming the federal government for Florida's financial woes, Gov. Rick Scott on Tuesday said he was prepared to call Florida lawmakers back for a special session to complete the budget — and even encourage them to pass a bare-bones budget if necessary. ... During a closed-door meeting, House Speaker Steve Crisafulli, R-Merritt Island, could be heard encouraging the Republican caucus to hold firm in its opposition to Medicaid expansion, one of the key sticking points of the session. "We're asking you to trust us," an Associated Press reporter heard Crisafulli saying. Senate President Andy Gardiner, meanwhile, received a standing ovation from the entire Senate — and applause from lobbyists and activists in the audience — when he said the Senate would continue its fight for expanded coverage. (McGrory and Van Sickler, 4/21)

With time running out, Florida Gov. Rick Scott on Tuesday injected himself into the state's ongoing budget showdown, telling Republican legislators that he would call them back into a special session if they fail to reach a deal soon. Scott made his suggestion at the end of a topsy-turvy day that witnessed GOP leaders in the Florida House and Senate remaining firm in their positions regarding health care funding and whether to expand Medicaid. The impasse means legislators will not pass a new budget by the May 1 end of the regular session. (Kennedy and Fineout, 4/22)

The federal government is balking at Michigan's approval request to continue health care coverage for nearly 600,000 low-income residents, state officials say. The development, they say, threatens the program's future. Under state law, Michigan must, by Dec. 31, receive a waiver from the Centers for Medicare and Medicaid Services on the health care cost-sharing requirements in its Medicaid expansion law — or the state's program will end. ... The program could continue if federal officials find a way to approve the waiver or if the Legislature changes the state's Medicaid expansion law to meet federal concerns. The final legislative approval of the expansion squeaked through the state Senate, 20-18, in August 2013, and political experts and lawmakers indicated Tuesday that changing the law would be an uphill battle. (Bouffard and Livengood, 4/21)