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Federal health officials said publicly for the first time Tuesday that they want expansion of Florida's Medicaid program as part of any deal to grant Gov. Rick Scott's request to help the state's hospitals treat poor patients. Scott, so far, is refusing and with neither side backing down, that could lead to the Legislature failing to pass a budget before the scheduled end of its annual session May 1. Senate leaders say they will not approve a final budget that includes large cuts to hospitals. (Fineout and Kennedy, 4/14)

The federal government Tuesday explicitly linked two Medicaid-related programs, a move that could escalate a fight that already threatens creation of a state budget in time for the Legislature's adjournment on May 1. Talks between Gov. Rick Scott's administration and the federal Center for Medicare and Medicaid Services to extend the Low Income Pool program, which expires June 30, recently broke down amid finger pointing on both sides. LIP pays hospitals and others who provide care to low-income patients. The Senate has created a budget with both LIP and Medicaid expansion money, while the House's spending plan does not include those funds, creating a $4.2 billion gap that must be reconciled before lawmakers can go home. (Rohrer, 4/14)

Federal health officials turned up the pressure on Florida Tuesday, saying the future of $1.3 billion in federal funding for hospitals that treat low-income patients is tied to whether the Legislature expands Medicaid. In a letter to Florida’s Medicaid director, a top federal official wrote that the federal government is willing to consider the state’s request to keep the so-called Low Income Pool (LIP) in place after the program ends in June. But U.S. Centers for Medicare and Medicaid Services Acting Director Vikki Wachino noted "the state's expansion status is an important consideration in our approach regarding extending the LIP program." (McGrory, 4/14)

After losing the fight to block Medicaid expansion, a Koch-funded conservative group served up a gaffe that has state Democrats and political observers rubbing salt into the wound. ... The state chapter of Americans for Prosperity ... issued a statement Thursday ... saying it contradicted the wishes of “millions of Montanans” who “do not want more Obamacare.” ... “Yesterday, a ‘grassroots’ organization talked about the things #MillionsOfMontanans did. What else have #MillionsOfMontanans done? #MTLeg,” [Democratic Gov.] Steve Bullock tweeted. ... Around 1.6 million Twitter users saw the tweets — 600,000 more than state’s population. ... The contentious Medicaid debate helped the joke take hold, as did the way the gaffe poked at AFP’s out-of-state ties. (Brouwer, 4/14)

As Gov. Chris Christie tells audiences in New Hampshire that he wants to cut Social Security and other entitlement spending, his move to expand Medicaid in New Jersey has angered some Republicans. Since the decision two years ago to expand Medicaid in New Jersey under the Affordable Care Act, 400,000 more recipients have enrolled, state officials say. Overwhelmed by the surge, some counties paid staff members overtime to process applications. (Dawsey and Haddon, 4/14)

By most accounts, the state’s Medicaid expansion has been a success -- but not for the 9,000 to 12,000 residents still waiting for their applications to be processed. The botched rollout of a new Department of Human Services computer system and a fragmented, county-focused Medicaid application system have been blamed for the backlog. (Kitchenman, 4/14)

Clayton-based Centene Corp. could finally make headway on its long-term goal to spread its business across the state, thanks to the Missouri Senate. Senators narrowly approved a Department of Social Services budget last week that expands managed care of the Medicaid program. The expansion would shift 200,000 parents and children receiving traditional Medicaid to privatized managed care, exempting the elderly, blind and disabled. This could mean more money for Centene, whose subsidiary, Home State Health Plan, was one of three companies awarded the state’s managed care contracts. (Stuckey, 4/15)

Patient advocacy groups and Medicaid officials sharply disagree on whether HIV/AIDS patients are receiving adequate access to specialists and medications as states increasingly shift this population from traditional Medicaid to Medicaid managed care. (Dickson, 4/14)