Nevada is taking steps toward leaving the federal healthcare.gov and setting up a separate exchange operated by the state.

The Nevada Appeal reports that the Legislative Interim Finance Committee on Friday authorized state officials to spend $1 million to prepare a request for proposals and find a private provider.

Heather Korbulic, executive director of the state system, says changes are needed because healthcare.gov is steadily raising the rates it charges states that link their front-end systems to the federal exchange.

. . .

Gov. Holcomb (R-IN) joined U.S. Health and Human Services Secretary Alex Azar at Eskenazi Hospital on Friday to announce Indiana gained federal approval to continue its Healthy Indiana Plan (HIP).

The plan, which the state calls a successful alternative to traditional Medicaid, has been approved through Dec. 2020.

This will allow the state to continue health coverage for more than 400,000 low-income adult Hoosiers.

The Healthy Indiana Plan was created in 2007 under Gov. Mitch Daniels. The program was expanded in 2015 by then Gov. Mike Pence with a federal waiver to implement HIP as an alternative to traditional Medicaid expansion.

. . .

States that run their own Affordable Care Act insurance market­places significantly outperformed the rest of the country in attracting consumers to sign up for health plans for 2018, according to enrollment tallies released Wednesday.

Overall enrollment stayed essentially level from the year before in the 11 states plus the District with state-based marketplaces, while sign-ups in states that rely on the ACA’s federal exchange fell, on average, by more than 5 percent. Five states with hybrid systems did best of all, according to a report compiled by the National Academy for State Health Policy.

. . .

A growing number of mostly Republican-led states are rushing to follow Kentucky’s lead in requiring thousands of people on Medicaid to work or lose health coverage.

The governors of South Dakota, Alabama, Louisiana and South Carolina have said in recent weeks that they plan to pursue work requirements for their Medicaid programs, following the Trump administration’s release of guidelines for the concept in January.

“Whenever possible, we should always endeavor to help South Carolinians in need find their path to gainful employment and away from temporary assistance of government,” South Carolina GOP Gov. Henry McMaster tweeted Jan. 11, the same day federal officials announced the new guidance.

. . .

Oregon voters recently upheld a myriad of new taxes that were passed as part of a major health-care law last summer. The state government is planning to use the estimated $320 million in revenue to cover hundreds of thousands of residents who have enrolled through the Affordable Care Act. The outcome of this vote has serious implications anyone enrolled in a health-care plan in Oregon.

The referendum was on sections of House Bill 2391, which imposes a 0.7 percent tax on small hospitals as well as a 1.5 percent on individual and family health-care premiums. These revenue raisers are intended to generate more tax dollars for the state. But they also allow Oregon to receive $630 million to $960 million in federal Medicaid matching funds.

. . .

Legislation to expand Medicaid in Virginia failed Thursday after a state Senate panel voted on party lines to defeat the measure.

The state’s Education and Health Committee voted down the bill 8-7. The bill can be brought up at another time, but if the committee doesn’t take further action, the bill is dead.

The bill, sponsored by state Sen. Emmett Hanger (R), would have directed the state’s secretary of Health and Human Resources to submit a Medicaid expansion waiver to the federal government.

. . .

Concerned about soaring health care costs, Idaho on Wednesday revealed a plan that will allow insurance companies to sell cheap policies that ditch key provisions of the Affordable Care Act.

It’s believed to be the first state to take formal steps without prior federal approval for creating policies that do not comply with the Obama-era health care law. Health care experts say the move is legally dubious, a concern supported by internal records obtained by The Associated Press.

. . .

Thousands of Medicaid recipients in Mississippi would be required to work to be eligible for the program if the Trump administration approves a controversial state waiver request that recently opened for public comment.

The proposal is likely to set off a firestorm of criticism from Democrats and health advocates, who argue that work requirements, combined with Mississippi’s strict Medicaid eligibility requirements, will result in thousands of people losing their coverage.

. . .

Oregon approved taxes on hospitals, health insurers and managed care companies in an unusual special election Tuesday that asked voters — and not lawmakers — how to pay for Medicaid costs that now include coverage of hundreds of thousands of low-income residents added to the program’s rolls under the Affordable Care Act.

Measure 101 was passing handily in early returns Tuesday night. The single-issue election drew national attention to this progressive state, which aggressively expanded its Medicaid rolls under President Barack Obama’s health care reforms. Oregon now has one of the lowest rates of uninsured residents in the nation at 5 percent. About 1 million Oregonians — 25 percent — now receive health care coverage from Medicaid.

. . .

Oregon aggressively expanded its Medicaid rolls under the Affordable Care Act, adding enough people to leave only 5 percent of its population uninsured — one of America’s lowest rates.

Now, with the reduction of a federal match that covered those enrollees, the state is calling on voters to decide how to pay for its ballooning Medicaid costs.

A special election on Tuesday asks Oregonians whether they approve of a tax on hospitals, health insurers and managed care companies that would leave Medicaid, as it is now, untouched. More than 1 in 4 residents here rely on it.

. . .