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All four of Louisiana's major gubernatorial candidates have said they'd be open to expanding Medicaid under the Affordable Care Act, a move that would expand health care coverage to nearly 300,000 people, according to one estimate, many of them working poor. But the three Republican candidates -- U.S. Sen. David Vitter, Lt. Gov. Jay Dardenne and Public Service Commissioner Scott Angelle -- say they'd seek a different version of the Medicaid expansion offered now, opening up a potentially lengthy and expensive process to obtain what's known as a waiver. Democrat John Bel Edwards has said he would accept Medicaid expansion without the waiver. (Litten, 10/21)

Is Gov. Robert Bentley nudging closer to expanding Medicaid under the Affordable Care Act? Listen to what the governor said Tuesday when asked the question. "You know I wouldn't say nudging toward it," said Bentley. "But we are certainly looking at that; not right now. We are not at that stage right now." But then the governor added this when asked about remarks he had just made to a group of seniors about the need to improve healthcare in rural areas and how Medicaid expansion might come into play: "But you know we do have to realistically look at whether we have adequate funding for rural doctors, primary care doctors. They cannot treat a third of their patients and stay in business. It is a business they run," said the governor. (Dean, 10/20)

Arkansas Department of Human Services Director John Selig said Tuesday he supports having a private company manage some portions, but not all, of the state's Medicaid program. Selig told a legislative task force that moving some of the program's more expensive clients to managed care makes more sense than shifting the entire program. A consultant told lawmakers this month that hiring a company to manage the care for the state's Medicaid program could save Arkansas billions of dollars. (DeMillo, 10/20)

Arkansas will have a better chance of controlling its Medicaid budget if it hires managed-care companies to handle benefits for nursing home residents, the disabled and other patients with expensive medical needs, the director of the state Department of Human Services told legislators Tuesday. John Selig, who plans to leave the Human Services Department at the end of this year, said the department has tried to implement changes in how it provides long-term services for the elderly, disabled and mentally ill, but with limited success. Private companies would likely have more flexibility, Selig said. (Davis, 10/21)

A bill under consideration in the state House would move the CHIP program, which provides free or low-cost health insurance to children, from the Department of Insurance to the Department of Human Services. Advocates say the switch would save the state money and would help families enrolled in the program. ... Thousands of children move between CHIP and Medicaid every month, however, as family incomes fluctuate and eligibility changes. Having one state agency manage eligibility determinations and one IT system would help provide more seamless coverage for children, state officials say. (Giammarise, 10/21)