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Gov. John Kasich’s administration projects more than 650,000 poor Ohioans will lose Medicaid coverage while taxpayers save nearly $1 billion under a plan to charge new fees for the government health coverage and impose penalties on those who miss payments. The proposal would require those being treated for breast and cervical cancer, teens coming out of foster care and other working-age, nondisabled adults on Medicaid to make monthly payments into a health-savings account to help cover their expenses beginning Jan. 1, 2018. (Candisky, 4/7)

In his 2015 budget proposal, Kasich, who is running for the Republican presidential nomination, suggested assessing premiums for adults above 100% of poverty. GOP state lawmakers last summer passed a bill to have it apply to all program beneficiaries. Pundits aren't sure that will help Kasich win votes among those in his party who did not approve of the Ohio governor's decision to expand Medicaid in 2013. On Monday, his administration posted a summary of a waiver the state plans to submit to the CMS for approval. (DIckson, 4/6)

House Speaker Taylor Barras has filed legislation that will allow hospitals across the state to be charged a first-of-its-kind fee that will help the state pay for the cost of Medicaid expansion. The bill is the result of several years of legislative work that began under former Gov. Bobby Jindal, a vocal opponent of Medicaid expansion. Despite Jindal's opposition, legislators were able to find workarounds for financing Medicaid expansion that allowed them to avoid Jindal's veto while constructing a mechanism that would allow the state to raise money to pay for expansion from health care providers. (Litten, 4/6)

A coalition working to expand Medicaid in South Dakota is racing to complete its work before a new president moves into the White House. The state has negotiated for years with the Obama administration to reach agreement on re-interpret federal policy on funding Medicaid-eligible American Indians. And in February, the governor's office learned that the federal government would accept the terms of a compromise if the state would expand Medicaid. But that progress could face a serious setback come November if a new administration clears out and replaces current staff at the federal health agencies that have worked with the state or moves to abolish the federal healthcare program for needy people. (Ferguson, 4/6)

Gov. Asa Hutchinson called the debate over Arkansas' hybrid Medicaid expansion a "watershed" moment on Wednesday, as lawmakers advanced his plan to keep and rework the program that provides subsidized health coverage to more than 250,000 people. The House and Senate are set to take up legislation Thursday outlining the Republican's proposal to keep the hybrid expansion after the plan easily cleared two committees at the start of a special session. (DeMillo, 4/6)