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A House committee tried to kill the last-standing Medicaid expansion bill Tuesday by heavily amending it and giving it an unfavorable report. Those moves led to the start of a procedural rules battle between Democrats and conservative Republicans that likely will take at least the rest of the week to resolve. (Baumann, 4/8)

One of the biggest bills in this year’s Montana Legislature remains in limbo. Wednesday at noon, the House rules committee will meet to decide whether a committee had the right to kill a Medicaid expansion proposal with a “do not pass” recommendation. The bill, by Great Falls Republican Senator Ed Buttrey, is a compromise plan that was passed last month by the state Senate. It would cover an estimated 45,000 low-income Montana residents, who would have to pay a small premium and take part in job training. (Jess, 4/7)

A Republican-controlled House committee Tuesday voted to kill the only remaining bill to expand Medicaid health coverage for thousands of low-income Montanans, but a rules battle over its survival tumbled into Wednesday. House Democrats, on the House floor, challenged the committee vote as improper, setting up further parliamentary action this week that could determine the bill’s fate. (Dennison, 4/7)

The House Finance Committee on Tuesday began digging in to Gov. Bill Walker's proposal to expand and reform Medicaid in Alaska. Walker has made expansion a priority and his administration sees expansion as going hand-in-hand with efforts to reduce and contain costs within the current Medicaid program. But some lawmakers have raised concerns with the potential impacts of adding more people to a system widely seen as currently unsustainable. Medicaid comprises about 60 percent of the state health department budget and is a driver of the state operating budget. (Bohrer, 4/8)

A growing standoff about health care is creating a divide between the Republican-controlled Florida Senate and Gov. Rick Scott. A Senate panel Tuesday refused to confirm a top appointee of the Scott administration after he would not answer questions about whether he supported the Senate plan to expand health care coverage to 800,000 Floridians. (Fineout, 4/7)

One day after Gov. Rick Scott came out against a Senate proposal to expand health care coverage to about 800,000 poor Floridians, a Senate panel declined to confirm Scott's pick for surgeon general. The Senate Health Policy Committee postponed the vote on Surgeon General John Armstrong on Tuesday after he repeatedly declined to give his opinion on the Senate's proposed alternative to Medicaid expansion. Senate Majority Leader Bill Galvano, R-Bradenton, later said Armstrong had failed to provide "an adequate answer" on the issue. (McGrory, 4/7)