In places like Iowa and Maryland, Medicaid expansion has significantly reduced the number of uninsured patients and helped hospitals. Republican efforts to revamp the health law and President Donald Trump’s proposed budget could push more Medicaid costs back to states, who say they likely can’t pay for the current programs.

The Wall Street Journal:
GOP’s Quandary Over Medicaid Plays Out In Iowa

Few issues are as fraught for the Republicans writing a health overhaul in the Senate as how to handle Medicaid. Iowa’s experience shows the delicacy of the issue. The state in 2013 used federal funds to expand Medicaid, while also imposing a small premium for certain beneficiaries. The number of uninsured Iowans dropped 38% between 2013 and 2015, according to a review of U.S. Census data by Families USA, a non-partisan health advocacy group. Almost 150,000 Iowans gained coverage under the Medicaid expansion, just part of the millions added to the program under the Affordable Care Act. (Peterson and Armour, 6/4)

The Baltimore Sun:
Maryland Advocates Resist Efforts To Target Medicaid In Federal Funding Fights 

Trump’s budget proposal would deepen those reductions by another $600 billion nationwide — leading to an estimated $2 billion annual loss in Maryland, according to the Maryland Center on Economic Policy. That number, which represents just under 5 percent of the state’s $43.5 billion budget, may explain why Republican Gov. Larry Hogan has been more vocal on the Medicaid cuts than any other provision included in the federal care legislation. It also partly explains why the legislation is facing skepticism on Capitol Hill, even among some Republicans who support doing away with Obamacare. (Fritze and Cohn, 6/3)

Pittsburgh Post-Gazette:
Bill Would Require Time Limits And Work For Medicaid Recipients In Pa.

A proposal in Harrisburg would make work requirements part of Pennsylvania’s Medicaid program, as well as impose a lifetime limit of five years for Medicaid eligibility. … While it’s unlikely the proposal would become law under Pennsylvania’s current Democratic governor, the idea is one that has been gaining more attention due to Republican control in Washington, D.C., and calls by some Republicans to cut Medicaid spending or completely restructure the program. (Giammarise, 6/5)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.