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Montana became the 30th state to opt into the health law’s expansion of Medicaid on Monday, after federal officials said they’d signed off on a plan under which the state would increase the number of low-income residents it covers but impose certain eligibility conditions. The announcement brings the Obama administration to a critical milestone in its effort to persuade states to go along with a key tenet of the Affordable Care Act, after a 2012 Supreme Court decision that effectively gave the states a choice over the matter. (Radnofsky, 11/2)

Montana officially became the 30th state to expand Medicaid under ObamaCare on Monday when the Obama administration approved its expansion plan. In April, Montana’s Republican legislature approved Medicaid expansion, but like other Republican-controlled states, it made some changes to put a conservative twist on the program. (Sullivan, 11/2)

Montana’s plan calls for some recipients to pay a token premium that still might pose a challenge for some living just above the poverty level. It also asks participants to take part in a job skills survey. Both of those features were the subject of intense negotiations between the state and federal governments. The state expects about 45,000 of the estimated 70,000 eligible low-income people to sign up. For many, it will just mean having access to check-ups and other wellness care, but for a few it could literally be a lifesaver. (Jess, 11/2)

The Democratic governor said gaining federal approval of the Montana plan was difficult after the nearly three-year fight to pass the compromise legislation. ... The state Legislature rejected a Medicaid expansion bill in 2013 and a proposed voter initiative failed to qualify for the 2014 election ballot. Bullock's plan was rejected again in this year's legislative session, but this time was replaced by a compromise bill sponsored by Sen. Ed Buttrey, R-Great Falls. Lawmakers passed that measure, but the state needed a waiver by the federal government because of the changes, such as charging premiums and outsourcing the program's administration to a third party. (Volz, 11/2)

The online federal insurance marketplace opened for business Sunday. It’s the third year of open enrollment for these subsidized plans, established by the Affordable Care Act. Many Texans still oppose the law, even though the state is home to the most uninsured people in the country. For the moment, Texas Republicans still consider the Affordable Care Act to be political kryptonite. ... But the story on the local level is different. Harris County is home to Houston, where Judge Ed Emmett, a moderate Republican who is chief executive for the county, has supported it for years. The CEO of the taxpayer-supported Harris Health System, George Masi, says he needs the revenue that Medicaid expansion would bring. He’s had to lay off more than 100 employees and cut back on charity care. (Feibel, 11/3)