As the patchwork of state decisions about Medicaid expansion unfolds across the country, several states have yet to finalize their decisions. Governors of both Arizona and Ohio support Medicaid expansion but face opposition from their legislatures. The Arizona Senate voted 19-11 on May 16 to approve an $8.8 billion state budget that includes a proposal for expansion. The expansion plan would cover people earning up to 138 percent of the federal poverty level. An additional 300,000 Arizonians would join the already 1.2 million people on Medicaid.

Population growth, an aging population and a dramatic rise in the number of insured Americans resulting from the Patient Protection and Affordable Care Act are creating a growing need for more primary care physicians nationwide. Despite the growing demand for health services, only 6 percent of doctors are licensed in three or more states, according to Lisa Robin, chief advocacy officer for the Federation of State Medical Boards. One possible solution to growing concerns about physician shortages may be an increased on license portability as a means to promote telehealth and allow doctors to more easily work across state lines. 

Governing reporter Dylan Scott wrote today about the start-up operations at the Rhode Island health insurance exchange. The staff’s white board counts down the 138 days to October 1 when uninsured Rhode Islanders will be able to buy health insurance through the exchange.  

Scott’s article provides insight into exchanges – how government is moving into selling health insurance and the challenges ahead. It’s a must read for anyone struggling to understand this new government endeavor.

“That sigh of relief you heard Monday was from hospital administrators in nearly two dozen states, including Florida and Texas.”

This is how the Kaiser Health News described the reaction to the Obama administration announcement that the anticipated reduction in special Medicaid payments to hospitals for care of the uninsured will not penalize states that have not expanded their Medicaid eligibility guidelines.

Elise Gould and Natalie Sabadish at the Economic Policy Institute recently took a look at health expenditure data and found some interesting patterns – chiefly that health spending in this country is distributed extremely differently among certain groups. As their cool infographic below shows, a big chunk of what we spend as a country on health care goes to a tiny fraction of the population. In fact, half of all health care dollars are spent by only five percent of the population, while the top 20 percent of spenders consume 82 percent of all health-care dollars.

Stateline Midwest ~ May 2013

New abortion laws and restrictions adopted by legislatures in the Midwest have once again attracted national interest. This year, the focus has been on bills signed into law in North Dakota and Kansas.

10 Questions with Oregon Gov. John Kitzhaber: Coordinating Care to Cut Medicaid Costs

Oregon Gov. John Kitzhaber, a physician, says his state’s new approach to Medicaid under a federal waiver has fundamentally changed the way health care is organized and delivered. It established coordinated care organizations, which are moving away from a fee-for-service model.

$2 Million Ad Campaign Opens in Colorado and Feds Release 3-page Application

Colorado is the first state to launch a major ad campaign to drive citizens to the state health insurance exchange to purchase insurance. Under the Affordable Care Act, the exchanges must be open for enrollment on October 1, 2013, and for coverage beginning January 1, 2014. This TV ad is airing in Colorado.