Now that Arkansas, Pennsylvania, and Iowa have gained federal approval of Medicaid expansion proposals that call for more use of private insurers than states that simply expanded their existing Medicaid programs, it looks as if other states may follow a similar path.

New Hampshire and Indiana are already pursuing federal approval of customized approaches to Medicaid expansion.  Now, it appears that Tennessee, Utah, and Wyoming may follow suit after the November elections, when the political implications of Medicaid expansion will not be as great for Republican governors.

Medicaid expansion is especially important for private safety-net hospitals because they serve so many more low-income patients than the typical American hospital.

For a closer look at how states have tailored their own Medicaid expansion programs under the Affordable Care Act, how those plans are working, and how the federal government is treating such proposals, see this Stateline report.