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Kansas’ Democratic governor said on Thursday that she had reached a deal with Republicans who control the Legislature to expand Medicaid under the Affordable Care Act. If lawmakers approve the plan in the coming weeks, it would end years of wrangling over the issue in a state that has endured a series of rural hospital closures. “It’s a lot easier to get to no than it is to get to yes, but this is what governing looks like,” said Jim Denning, the Republican leader in the Kansas Senate, who negotiated the agreement with Gov. Laura Kelly, a Democrat who took office last year after eight years of Republicans controlling state government. (Smith and Goodnough, 1/9)

The plan from Democratic Gov. Laura Kelly and Senate Majority Leader Jim Denning would give Kelly the straightforward expansion of state health coverage that she has advocated, covering as many as 150,000 additional people. But Denning would get a version of a program that he has proposed for driving down private health insurance premiums to make it less likely people would drop existing private plans for Medicaid. Denning had proposed financing his new program by increasing tobacco taxes, including a $1-per-pack increase in the state's cigarette tax, to $2.29. His compromise with Kelly gives the state a year to develop the premium-reduction program and drops the tax increase, which Kelly and many lawmakers thought wasn't likely to pass anyway. (1/9)

Kelly's plan increases Kansans' Medicaid eligibility to 138 percent of the federal poverty level, works to defray costs through a surcharge on hospitals, and includes a work training and placement program that is less stringent than the work requirements that many Republicans desired. It also will create an easy escape hatch for Kansas in case the federal government chooses to no longer provide 90 percent of the funding for Medicaid expansion and also moves forward with a program to help insurance programs provide cheaper health care on the federal exchange. (McCausland, 1/9)

Between 130,000 and 150,000 people are expected to be covered by Medicaid expansion in Kansas, mostly adults without children or parents currently ineligible for benefits despite living in or near poverty. Roughly 9 percent of Kansans are uninsured. (Scott, 1/9)

On the Republican end of the deal, Denning touted that the state would also set up a “reinsurance” program, which other states have adopted to help lower premiums in the Affordable Care Act markets for those with private insurance. Democrats also support that idea. (Sullivan, 1/9)

Despite past disagreements, the two had incentive to find common ground. Denning, expected to face a tough re-election campaign, had vowed to develop an expansion plan. And Kelly’s proposal had passed the House but languished in the Senate, leaving one of her signature goals unaccomplished in 2019. (Shorman, 1/9)

If signed into law, the compromise would make Kansas the 38th state to expand Medicaid (counting the District of Columbia). It would also end a partisan standoff that began nearly a decade ago with the passage of the federal Affordable Care Act. That law — better known as Obamacare — requires the federal government to shoulder 90 percent of the cost of expansion. (McLean, 1/9)

Gov. Andrew Cuomo says he's sick of paying New York City's medical bills. In his State of the State address, the governor signaled he hoped to sooth the state's swollen $6 billion budget deficit by making City Hall and other local governments swallow $4 billion in Medicaid costs. New York's enlarged and politically sensitive low-income insurance program accounts for the majority of the shortfall projected for the coming fiscal year. (Bredderman, 1/9)

As Florida lawmakers prepare to start the 2020 legislative session, the state is being confronted with a $70.4 million loss in the coming months in the amount of Medicaid money it gets to fund hospitals, train future physicians and treat people who are mentally ill. Amy Baker, who leads the Legislature’s Office of Economic and Demographic Research, is including the reduction --- slated to take effect May 23 --- in budget documents prepared for lawmakers as they begin working on a fiscal 2020-2021 spending plan. (Sexton, 1/9)

The State Auditor’s office says it cannot determine whether home health care claims are being paid properly under Iowa’s privatized Medicaid system because data provided by the Department of Human Services is inaccurate and inconsistent. State Auditor Rob Sand said his office requested information about home health services provided from April 2016, when the state initiated its privatized Medicaid system, though the end of 2018. (Gerlock, 1/9)