Medicaid Expansion Debate Update: Montana, Florida, Alaska Could Still Approve Medicaid Expansion

Efforts to expand Medicaid stayed alive in Alaska, Florida and Montana legislatures this week, while a proposal to do so in Nebraska was voted down in the state's legislature. Under the Affordable Care Act, states have the option of broadening eligibility for the government health insurance program to include adults whose income is up to 138 percent of the federal poverty line.

An expansion seems imminent in Montana, where the House approved a Medicaid expansion bill Thursday in a vote of 54-46. The bill has already passed the Senate and is supported by Gov. Steve Bullock, a Democrat, who is expected to sign it. Both the Senate and the House in Montana are controlled by Republicans. About 70,000 people would be eligible for coverage in Montana under an expanded Medicaid program.

Alaska's House Finance Committee discussed its own Medicaid expansion this week, but Republicans in both the House and Senate have said the bill needs to be revised to cut costs, the Alaska Journal of Commerce reports. Alaska Gov. Bill Walker submitted legislation in March to expand Medicaid to 42,000 Alaskans.

In Florida, Republican Gov. Rick Scott said this week that he opposed expanding Medicaid, in contrast to a previous stance. Florida's legislature is sharply divided on the issue, with the state Senate supporting its expansion and several House Republicans strongly opposing it. If Florida expands Medicaid, about 800,000 people would be eligible for coverage.

These states have varying amounts of time to work out potential deals to expand Medicaid, as Alaska's legislative session adjourns April 19, Montana's April 29, and Florida's May 1, according to MultiState Associates.

In Nebraska, state legislators voted 28-16 Wednesday against a bill to expand Medicaid, the Associated Press reports. It was the third time lawmakers in the state, which has a one-body legislature, have unsuccessfully attempted to make Medicaid available to more low-income adults.

The Affordable Care Act, also known as Obamacare, initially required states to expand Medicaid to include adults whose income was up to 138 percent of the federal poverty line, but a Supreme Court decision in 2012 later made this expansion optional. Twenty-eight states, plus the District of Columbia, have opted to expand Medicaid so far.