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As Republicans in Congress prepare to repeal and replace former President Barack Obama's health care law, Kentucky's current governor and his predecessor are wrestling over the law's legacy -- and both sides claim the state as a case study of the law's impact. Former Democratic Gov. Steve Beshear embraced the Affordable Care Act, expanding Kentucky's Medicaid program and setting up a state-run health insurance exchange. But Matt Bevin, Beshear's Republican successor, quickly dismantled the state exchange and has applied for a waiver to overhaul Medicaid with the goal of moving people off the publicly-funded program and onto private insurance plans. (3/1)

Republican legislative leaders in Indiana are warning that repealing the Affordable Care Act could unravel a program for poor residents that Vice President Mike Pence implemented as governor, a conservative blueprint for expanding Medicaid under the federal law. Indiana House Speaker Brian Bosma and GOP Senate leader David Long both said this week that tens of thousands of poor people could lose their insurance if Republicans in Washington enact some of the ideas they're discussing for repealing President Barack Obama's signature health care law. (3/1)

Top Republicans – including President Donald Trump – have been huddling today to discuss ways to repeal and replace Obamacare. No doubt one item is on the agenda — shrinking Medicaid, the health program that serves 70 million Americans, people with disabilities, the elderly and those with low incomes. ... Republicans have long believed Medicaid costs too much. And it’s true, the program grows faster than the national economy, and it’s always one of the most expensive line items for states. The thinking, said [Lanhee] Chen, is that belt tightening will help states do more with less. “For states, sometimes when they have this fiscal pressure, it allows them to streamline the program, it allows them make their program more responsive. But I don’t think anyone should make the claim that it’s going to be easy for states,” Chen said. (Gorenstein, 3/1)

Expanding the state’s Medicaid program in 2018-19 and providing more funding to address the state’s opioid crisis are among the top priorities of Gov. Roy Cooper’s budget when it comes to health care. The budgets for the next two fiscal years, unveiled Wednesday, would provide a $3.76 million Medicaid rebase adjustment for 2017-18 and a $112.6 million adjustment for 2018-19. (Craver, 3/1)

For years, Texas GOP leaders have said they’d gladly give up open-ended flows of federal Medicaid money for a set “block grant” that lets them run the health insurance program for the poor the way they want. ... Block grants and per capita caps, though, would be a high-stakes roll of the dice for Texas, a new private study has warned. “Capped Medicaid financing shifts the risk of any costs above the federal caps to the states,” said the study, conducted by Washington, D.C.-based Manatt Health for the Texas Alliance for Health Care. It is a year-old coalition of health care providers, insurers, business groups and patient advocates. (Garrett, 3/1)

The measure would require the state Department of Human Services to seek a federal waiver or waivers allowing it to stop enrolling people in the program known as Arkansas Works, formerly the private option, on July 1. The program, Arkansas' alternative to the expansion of Medicaid rolls envisioned in the federal Affordable Care Act, provides government-subsidized private health insurance, mostly funded by the federal government, to Arkansans earning up to 138 percent of the federal poverty level. (Lyon, 3/1)

The House on Wednesday voted to halt enrollment into the Arkansas Works program after a debate about what the federal government is likely to do to change health care policy. House Bill 1465 by Rep. Josh Miller, R-Heber Springs, passed 55-32. It heads to the Senate for further consideration. (Fanney, 3/2)

MDwise, an Indiana health insurer, has announced it will lay off about 80 employees because it is pulling out of an insurance program the state designed to care for some of its sickest and poorest residents. The company made the decision to leave the Hoosier Care Connect program at the end of this month because of a dispute with the Indiana Family and Social Services Administration over payment, company officials said in a statement. (Rudavsky, 3/1)