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Republican-led states that already expanded Medicaid now are coming back to the Obama administration with requests to move their expansion programs in more conservative directions, including higher cost sharing for beneficiaries, work requirements, and coverage time limits. These moves may test the limits of the administration's flexibility and could lead to rollbacks in Medicaid expansion across the country. (Dickson, 5/7)

The Legislature has been in special session for ten days, and held a half dozen budget hearings. On the other issues lawmakers have been called back for — Medicaid expansion and a sexual abuse prevention program — there have been zero meetings. The special session has mainly been characterized by gridlock. ... [Attorney Douglas] Mertz says there could be some merit in bringing in a third party to help guide the key players. And there’s precedent. (Gutierrez, 5/7)

[T]he debate over the 2010 law has roiled Florida's politics in ways unimaginable in many other states, especially those like Florida in which Republicans control the government. Florida lawmakers have fought so bitterly over the question of expanding Medicaid under the Affordable Care Act that the Senate last month sued the House for cutting short its legislative session before finishing the state budget. The challenge they face is figuring out how to provide healthcare for the poor without participating in a law most of the state's GOP leadership detests. (Berman, 5/8)

Gov. Rick Scott took another jab at the Obama Administration Thursday, asking the court to take immediate action in his lawsuit against federal healthcare officials. The lawsuit, filed last week in federal court, alleges that the U.S. Department of Health and Human Services is trying to coerce Florida into expanding Medicaid by threatening to end a $2.2 billion program that helps hospitals pay for uncompensated care. The Republican governor now wants a court-ordered injunction to stop federal health officials from tying the two programs. (McGrory, 5/7)

The top executive at Georgia's largest safety-net hospital said Thursday he is pleased to see signs that state officials could seek federal approval to make changes to its Medicaid program. The state budget awaiting Republican Gov. Nathan Deal's signature includes a provision allowing state health officials to seek a waiver from federal Medicaid authorities. The same strategy, called a Section 1115 waiver, has been used in conservative states where governors resisted full Medicaid expansion under the Affordable Care Act but worked with federal officials to craft alternatives that still covered more people. (Foody, 5/7)