Maine’s Republican governor has said federal regulators want to know how Maine would pay for Medicaid expansion. But it’s unclear just how that issue will play out in Maine, the first state to pass Medicaid expansion under Republican President Trump’s administration.

States must file routine paperwork to get federal Medicaid expansion funding under former Democratic President Obama’s signature health care law. The Centers for Medicare & Medicaid Services told The Associated Press on Tuesday that it works to ensure states pay for their share of an expansion with “proper” financing.

The Wisconsin Department of Justice has filed a new lawsuit against the federal government over a fee for health insurers under the Affordable Care Act.

State Attorney General Brad Schimel announced last week the state had filed the lawsuit, along with a motion for a temporary restraining order against President Donald Trump’s Administration, as the deadline nears for Wisconsin to pay more than $30 million through the health insurance providers fee.

States serve as “laboratories of democracy,” as U.S. Supreme Court Justice Louis Brandeis famously said. And states are also labs for health policy, launching all kinds of experiments lately to temper spending on pharmaceuticals.

No wonder. Drugs are among the fastest-rising health care costs for many consumers and are a key reason health care spending dominates many state budgets — crowding out roads, schools and other priorities.

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Comments close soon on New Hampshire’s new Medicaid waiver application. The Granite State is one of several states to already have a work requirement approved, and they want to continue it, which is what understandably gets the most attention.

But New Hampshire is also making another change to their Medicaid expansion plan, one that helps signal the end of an era for the program, the quiet death of what was once thought to be a promising conservative alternative to a conventional Medicaid expansion.

New Hampshire wants to end its Medicaid premium assistance program.

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States have often been an incubator for innovative ideas in health technology pricing and reimbursement. In another example of necessity being the mother of invention, Medicaid expansion coupled with rising drug costs have forced state Medicaid authorities to seek new payment mechanisms that would contain drug costs. In June of this year, the Centers for Medicare and Medicaid Services (CMS) gave the green light to Oklahoma to pursue a Medicaid drug pricing initiative.

Californians have always had the freedom to purchase “short-term” health insurance. Short-term plans have traditionally filled gaps in coverage, such as when consumers are between jobs or nearing Medicare eligibility. They often cost 70 percent less and offer greater choice of doctors than ACA plans.

Part of the fun of running for office appears to be taking creative liberties with your opponent’s record, so get ready for a fiction-filled autumn. An early ObamaCare misdirection out of Wisconsin is one that Republicans nationwide will have to anticipate.

A type of health insurance plan encouraged by President Trump, in which workers band together to get coverage, has applied to cover residents in Nevada.

The plans, known as “association health plans,” have been framed by the White House as a cheaper option for insurance coverage than Obamacare. Critics and pro-Obamacare groups have warned consumers that the plans may not be as extensive as those offered under the healthcare law.

Attorney General Ken Paxton today commended a U.S. District Court decision ordering the Internal Revenue Service to repay Texas and five other states more than $839 million because of an unlawful Obamacare tax on state Medicaid programs. Of that total amount, Texas stands to be repaid $304,730,608.

“Obamacare is unconstitutional, plain and simple,” Attorney General Paxton said. “We all know that the feds cannot tax the states, and we’re proud to return this illegally collected money to the people of Texas.”

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Medicaid is meant to serve as a backstop for the truly disadvantaged. It’s not supposed to be a replacement for a job. Physically able enrollees ought to work in exchange for their benefits.