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"The relentless economics of the U.S. health care system have sapped resources in poor areas for decades as hospitals and doctors follow the money in the form of well-insured patients. Doctors and medical care facilities serving large numbers of poor patients have trouble staying afloat because uninsured patients and those on Medicaid are expensive."

"University System of Maryland schools have had mixed success in improving the graduation rates of minority and low-income students, according to an annual progress report released this week. Some colleges, including the University of Maryland, College Park and the University of Maryland, Baltimore County, have been able to boost minority and low-income achievement. But at other schools, the gaps between those students and middle-class whites have increased in recent years."

"Gov. Paul LePage's decision to shrink Medicaid instead of expanding it was a radical departure from a decade-long effort to cover more people in this small rural state of farmers, lobstermen, craftsmen and other seasonal workers, which at least until recently, boasted one of the lowest rates of uninsured in the nation. Maine was the only state in New England, and one of 23 nationally, to decline federal money to expand Medicaid under the federal law."

"If the 23 states that have rejected expanding Medicaid under the 2010 health-care law continue to do so for the next eight years, they'll pay $152 billion to extend the program in other states -- while receiving nothing in return. This exodus of federal tax dollars from 2013 through 2022 would pay 37 percent of the cost to expand Medicaid in the 27 remaining states and Washington, D.C., over that time. Most of the money, nearly $88 billion, would come from taxpayers in just five non-expansion states: Texas, Florida, North Carolina, Georgia and Virginia."

"Some Missouri Republicans say they're willing to expand Medicaid - provided that new recipients look for jobs as a condition of eligibility. But a new agreement between the federal government and Pennsylvania suggests that strategy probably won't work. Pennsylvania's plan to provide coverage to as many as 600,000 low-income residents was approved last week, but only after its work-search requirement was dropped after stiff resistance from the federal government"

"Georgia has opted out of expanding Medicaid under Obamacare, aiming to avoid increased costs. On top of that, at the close of this year's legislative session Gov. Nathan Deal signed a bill making sure Medicaid cannot be expanded in Georgia without approval by the legislature. HB 990 bars any expansion of Medicaid eligibility 'through an increase in the income threshold without prior legislative approval.' The law specifies the approval must be by a legislative act or joint resolution of the General Assembly. Maybe this is a hedge against the possibility of pro-Medicaid expansion Democratic nominee for governor Jason Carter winning in November? Carter, trailing Deal, is trying to make Medicaid a key issue in the race."

"MaineCare, the state's Medicaid program, has an annual budget within the DHHS of roughly $2.4 billion a year, Mayhew told the Rotarians. She added that at the start of his administration, Governor Paul LePage requested more than $200 million to stabilize the foundation of the program. In Fiscal Year 2014, she said, there was zero-percent growth in MaineCare spending as the DHHS seeks to identify deficiencies and provide services to those who need it most namely, seniors and individuals with disabilities."

"Transportation tied in with one of the other main topics discussed at the meeting, the expansion of Medicaid in the state. Medicaid funds can be used as match money for new vehicle and operational costs, Seurer said. Perhaps not surprisingly, Democrats and Republicans debated the pros and cons of Medicaid expansion. Earlier this year, the Legislature voted along party lines not to expand Medicaid benefits to more low-income residents."

"It turns out that the Republican-led General Assembly did give a substantial tax break to people other than the rich. The problem is that the relief went to people in other states. A McClatchy Newspapers analysis shows that the legislature's refusal to expand Medicaid means that North Carolina taxpayers could spend more than $10 billion by 2022 to provide medical care for low-income residents of other states. For its largess, North Carolina will get nothing."

"From 2013 to 2015, the new report says, federal spending on Medicaid will increase 27 percent to $323 billion, from $254 billion. In those years, it said, Medicaid spending by state and local governments will rise 12 percent to $218 billion, from $195 billion. The federal government will initially pay all the costs resulting from the expansion of Medicaid eligibility in states that choose to cover certain childless adults with low incomes. States will have to pay some of the cost for new beneficiaries who could have qualified for Medicaid under old eligibility rules."