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The Republican-dominated Legislature convenes Wednesday for its fiscal session. At stake is the future of the Arkansas version of Medicaid expansion that provides health insurance to about 267,000 low-income Arkansans. ... Twenty-seven votes are required in the 35-member Senate and 75 votes in the 100-member House to reauthorize use of federal Medicaid dollars to purchase private health insurance for low-income Arkansans in fiscal 2017, which starts July 1. "It is going to be a hard lift, absolutely," said Sen. David Sanders, R-Little Rock, one of three legislative architects of the private-option program that Gov. Asa Hutchinson calls Arkansas Works. (Wickline, 4/10)

Hutchinson has said that while he opposes the Affordable Care Act, continuing Medicaid expansion is the best path forward for the state. The program is projected to save Arkansas $757 million over the next five years and help rural hospitals stay afloat. Thirty House members and 10 senators, all Republicans, voted against the bill to create Arkansas Works last week. ... The opponents’ votes were not enough to stop the legislation from passing during the special session, but they would be enough to block an appropriation bill. (Lyon, 4/10)

Arkansas Gov. Asa Hutchinson signed into law Friday his plan to keep the state's first-in-the-nation hybrid Medicaid expansion and urged fellow Republicans to avoid a Washington-style shutdown fight over their efforts to defund the program. The bills outline Hutchinson's proposal to rework the program, which uses federal funds to purchase private insurance for more than 250,000 low-income people. (DeMillo, 4/8)

Democrats frustrated at the Republican-led House and Senate majorities’ pursuit of a lawsuit against Gov. Bill Walker for authorizing Medicaid expansion attempted Friday to de-fund continued legal action. In both bodies, the attempts were defeated along majority/minority lines. (Brooks, 4/10)

Minority Democrats unsuccessfully sought to force a vote on whether the Legislature should continue pursuing a challenge to Gov. Bill Walker's authority to expand Medicaid on his own. (4/8)

Utah's governor and lawmakers have agreed on a pared-down plan to expand Medicaid after wrestling with the issue for years, but the law still needs approval from federal officials. The plan, which Gov. Gary Herbert approved in late March, is estimated to insure about 16,000 people, mostly childless adults who are homeless or in treatment and offender programs. (4/10)

Women outnumber men 2 to 1 in new Delaware Medicaid enrollees, which officials say signals a concerning trend around the number of women in poverty in the state. Since Delaware expanded its Medicaid program through the Affordable Care Act in January 2014, women have overwhelmingly enrolled for benefits. New data unveiled at the monthly Delaware Health Care Commission meeting showed that at the end of January women made up 63 percent of the 9,896 new enrollees. (Rini, 4/11)