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The Florida House overwhelmingly approved a $76.2 billion budget Thursday that was more than $4 billion less than the Florida Senate plan passed a day earlier, a discrepancy largely due to the House's staunch refusal to expand Medicaid. House leaders are adamant they aren't about to back off, even if it means that the two chambers, both controlled by Republicans, won't come to an agreement by the scheduled end of the legislative session in May. ... Senate President Andy Gardiner, R-Orlando, responded that he wasn't going to "rant and rave" about the issue of expanding federal Medicaid assistance to the poor. "This is a serious matter," he said. "This is a $2.2 billion hole, 800,000 people not covered." (Van Sickler and McGrory, 4/2)

In the most adamant remarks yet from House leaders, Rep. Richard Corcoran, R-Land O’Lakes, said Thursday the chamber “won’t dance” with the Senate on Medicaid expansion. ... His remarks were part of staunch defense of the House position to refuse a Senate plan to offer Medicaid eligibility to 800,000 Floridians making up to 138 percent of the federal poverty level, or about $33,000 a year for a family of four. (Rohrer, 4/2)

Rep. Richard Corcoran, the House budget chief who is the ideological force behind the House's resistance to Medicaid expansion, declared rhetorical war on the Senate Thursday in his closing arguments in support of the House's $76.2 billon budget. In a fiesty speech after nearly three hours of debate over the budget, Corcoran said the federal government's threat to cancel the cost-sharing program for hospitals known as the "Low Income Pool" is holding the state hostage and blasted his Senate colleagues for using the force of their budget to provoke a renewed debate over Medicaid expansion. (Klas, 4/2)

Federal health officials said Thursday that they are still negotiating with the state over the potential loss of more than $1 billion for Florida hospitals, despite assertions that talks were being halted. Officials at the Centers for Medicare and Medicaid Services have "not stopped conversations with the state of Florida," spokesman Aaron Albright said. "CMS remains in contact with state officials and continues to share information. Senior officials from CMS will continue conversations with state officials." (Kennedy, 4/3)

The sole surviving bill to expand Medicaid in Montana has its first hearing in a House committee next Tuesday -- and Democrats already are angling to move it to the floor and bypass the committee. ... SB405, sponsored by Sen. Ed Buttrey, R-Great Falls, would expand Medicaid in Montana to provide health coverage for tens of thousands of low-income Montanans and accept federal money to pay for the expansion. The bill passed the Senate this week, but SB405 is expected to have a more difficult time in the House, where GOP leadership has vowed to defeat it. (Dennison, 4/3)

A selling point for expanding Medicaid in Montana is that it should reduce health care prices and insurance rates for everyone -- but its biggest backers say those reductions aren’t a sure thing. If the Legislature agrees to expand Medicaid, an estimated 26,000 to 33,000 low-income Montanans without health insurance would be covered the next two years. Hospitals and others supporting the expansion say they will start getting paid for services they now provide as charity -- and that payment will reduce cost-shifting to customers who are insured. Yet an executive with the MHA, the lobby for Montana’s hospitals, says reducing cost-shifting doesn’t necessarily mean a direct cut in health care prices. (Dennison, 4/3)

For his Medicaid expansion plan to be successful, membership will decrease, Sen. Ed Buttrey said Thursday at a roundtable on his HELP Act at Benefis Health System. The Great Falls Republican's bill, whose full name is Montana Health and Economic Livelihood Partnership, would accept federal funds to expand Medicaid coverage to people whose income is below 138 percent of poverty level. The bill also has a job-training component, with people who enroll asked to participate in a Department of Labor and Industry workforce assessment survey for the creation of a job placement plan. (Wipf, 4/2)