Medicaid Expansion - Even More Changes

Bill H 328 has been modified and renamed to H 345

Key Differences:

Repeal of Medicaid Expansion:

HB 328: Included a conditional repeal of Medicaid expansion if federal approvals weren’t met, threatening to undo the 2018 voter initiative.

HB 345: Removes the repeal provision entirely, preserving Medicaid expansion as a baseline.

Enrollment Restrictions:

HB 328: Could cap enrollment at less than half of current levels and kick off enrollees after three years.

HB 345: Drops these caps and time limits, focusing on reform rather than restriction.

Scope of Reform:

HB 328: More aggressive, with 11 specific federal policy demands, making it riskier and less flexible.

HB 345: Streamlined to focus on work requirements, tax credits, and managed care, aiming for broader legislative support.

Legislative Viability:

HB 328: Stalled in the Senate, facing resistance due to its repeal clause and complexity.

HB 345: Introduced as a response to HB 328’s struggles, with a cleaner approach to gain traction; still early in the process.

Tone and Intent:

HB 328: Positioned as a high-stakes ultimatum to force federal compliance or revert to pre-expansion policy.

HB 345: Frames itself as a practical cost-control measure without threatening the core of Medicaid expansion.