There has been some interesting movement this past week around the Medicaid expansion issue, especially in Tennessee.  One emerging theme continues – development of state-created alternative plans to use the Medicaid dollars while still extending health coverage to newly eligible low-income adults.  Here are some of the more interesting stories:

Obviously Tennessee leads here with the surprising announcement by Governor Haslam of a comprehensive alternative Medicaid plan with broad political support.  More analysis on this from my Georgetown colleague Sean Miskell.

A new report on the proposal being mulled by Governor Otter in Idaho projects $173 million in state budget savings from the public/private hybrid Medicaid reform approach.

Then a Wyoming legislative committee advanced – with considerable changes – an alternative Medicaid expansion plan after considering Governor Mead’s SHARE plan approach.  Expect more debate in January, with all options – including Mead’s SHARE plan still on the table.

The best quote of the week comes from Alaska’s brand new Health Commissioner, Valerie Davidson, who announced her determination to work hard with all sides to craft an alternative Medicaid plan:  “If it’s 40 below we go about our day and get things done.“

In Nebraska, the Nebraska Farmers Union announced their support for a Medicaid expansion plan: “We have to remember where we started here,” Hansen tells Ken Anderson with Brownfield Ag News, “The economic impact of major medical events for folks in rural Nebraska who either couldn’t afford health insurance or, in a lot of cases, were not eligible for health insurance by virtue of a pre-existing condition was the number one reason for farm bankruptcies.”

Next, here’s a nice analysis of an alternative Medicaid expansion plan for Florida crafted by a consortium of business groups in the state.  The business plan throws a wild card into an already robust debate on accepting the available federal money to extend coverage.

And finally, the Montana Chamber of Commerce released a survey showing that a majority support in the state for extending coverage by using the available federal Medicaid dollars.  The result was even more surprising as the question polled asked only about covering “childless adults” and not the many parents, people with disabilities, and older people who would also gain coverage.

While there will be a lull in these discussions over the next few holiday weeks, expect more to come in the first months of 2015.  The massive amounts of available federal funding for extending coverage coupled with the continuing move from ideologically-driven debate to practical policymaking continues to drive this debate.