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The federal government is holding state leaders’ feet to the fire, hoping to get Texas to expand its Medicaid program to provide health insurance to more low-income Texans. Federal officials called the state's health agency this week to say that Texas' reluctance to expand Medicaid — a key tenet of President Obama's signature health law — will play into whether his administration extends a waiver that helps the state's hospitals cover uninsured patients. (Walters, 4/17)

Missouri Republicans said early in the session Medicaid expansion was a non-starter again this year and despite Democratic attempts to address the issue using amendments and protests, they've stuck true to their word. But Republican leaders have also said they want to see reforms to the Medicaid system. Some tweaks to the state's Medicaid system are moving forward, including proposals encouraging the use of telemedicine, a raise to the asset limit for people with disabilities and more stringent policing of eligibility. (French, 4/19)

Even as lawmakers celebrate the demise of the SGR, their success on that issue may have shifted pressure onto a different one: the Children’s Health Insurance Program. (Mershon, 4/17)