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Governors of both parties are warning that a little-noticed regulation proposed by the Trump administration could lead to big cuts in Medicaid, restricting their ability to pay for health care for low-income Americans. The arcane fiscal accountability rule proposed by the Centers for Medicare and Medicaid Services — or CMS — would tighten federal oversight and approval over complex financing strategies states have long used to help pay for their share of the $600 billion program. (Alonso-Zaldivar, 2/5)

State officials are seeking to change health care coverage for the nation’s poorest individuals, with Democrats trying to expand Medicaid to cover more people while Republicans aim to save costs over time. Democratic governors in at least three states with Republican-controlled legislatures are ramping up efforts to pass legislation to expand the program. At the same time, states like Michigan have begun implementing aspects of their requirements that people receiving Medicaid work, which could lead to fewer people being covered if that is upheld in the courts. (Raman, 2/5)

Gov. Mike Dunleavy released his supplemental budget proposal Wednesday, asking for more than $265 million from the Legislature for costs incurred during the 2020 fiscal year. The largest costs in the supplemental budget are $120 million for Medicaid services and more than $110 million for the firefighting efforts over the summer to combat the state’s wildfires. (Segall, 2/5)

In a rare break from Tennessee's conservative majority, a Republican has introduced a bill that would make the Volunteer State the latest to expand Medicaid under the Affordable Care Act. Rep. Ron Travis, R-Dayton, filed a bill Wednesday largely based on former Gov. Bill Haslam’s failed 2015 Medicaid expansion proposal, known as Insure Tennessee. If passed, the legislation requires Gov. Bill Lee to submit a waiver amendment to federal officials within 180 days and seek "medical assistance coverage for the same population groups and services as the Insure Tennessee proposal." (Elbert and Kelman, 2/5)

Gov. Bill Lee intends to extend TennCare’s postpartum insurance from two months to a full year in response to the preventable deaths of dozens of Tennessee mothers who were uninsured. Lee announced the coverage extension as part of a three-year pilot program during his State of the State speech on Monday night. The governor also revealed plans to expand TennCare dental coverage to women during pregnancy and after birth, saying coverage will “support improved health outcomes for both mother and child.” (Kelman, 2/4)

Florida House Speaker Jose Oliva and his allies have loudly contended during the past two years that there’s too much government interference in health care, leading to monopolies and rising costs. Despite that mantra, House Republicans have tucked into a budget bill mandates that would increase the role of government in Medicaid contracts negotiated between managed-care plans and providers. (Sexton, 2/5)