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Democratic lawmakers are grappling with how to extend health insurance to millions of poor Americans in states that have refused Obamacare’s Medicaid expansion, believing their upcoming party-line “human infrastructure” package represents the best chance to plug the health law’s biggest gap. After months of behind-the-scenes discussions, Democrats are coalescing around three options for closing the coverage gap in the Medicaid expansion holdout states, according to nine sources on and off the Hill. These approaches, which would leverage the existing Obamacare insurance marketplaces or require the Biden administration to create a new coverage program, each carry risks. And lawmakers still don’t see a clear path forward as they face a narrowing window to assemble a massive package of Democratic priorities. (Roubein and Miranda Ollstein, 7/10)

Chief Justice John Roberts closed the latest Supreme Court term earlier this month with the fight over work requirements for Medicaid beneficiaries unresolved. Trump administration approvals of programs in Arkansas and New Hampshire requiring all Medicaid beneficiaries to work or participate in job-skills training to remain eligible for the health-care coverage sparked the dispute. The justices put the case on hold in April after the Biden administration announced the Centers for Medicare & Medicaid Services was withdrawing the prior administration’s approvals. The case is now on life support and likely won’t be fully put to bed until early next term, some health law scholars say. The delay gives Arkansas time to pursue its administrative appeal of the Biden administration’s decision to withdraw the prior approval even though it’s unlikely the state will prevail. (Wheeler, 7/12)

The Biden administration’s decision to reevaluate Georgia’s plan to overhaul how state residents buy health insurance under the Affordable Care Act came as a “surprise” and suggests it wants to revisit the plan’s approval, which is not allowed, Gov. Brian Kemp’s office said. Georgia’s plan — dubbed “Georgia Access” — would improve the experience of shopping for insurance and encourage the private sector to enroll uninsured Georgia residents, the director of Kemp’s Office of Health Strategy and Coordination said in a letter to the federal Centers for Medicare and Medicaid Services. (Thanawala, 7/10)

As the Missouri Supreme Court prepares to hear arguments on the future of Medicaid in the state next week, groups are declaring their support for or opposition to its expansion. Health organizations, providers and business groups from around the state, as well as the House of Representatives, have submitted amicus briefs, or documents expressing their interest and support in the case. The high court will hear arguments on July 13. (Bacharier, 7/10)

Ohio plans to let more women be eligible for Medicaid for a year after giving birth, which advocates hope will lead to more new moms getting the care they need. When the American Rescue Plan passed, it included federal support for states that expand eligibility for Medicaid coverage for women until a baby’s first birthday. The newly based state budget calls for Ohio Medicaid to take up this offer, as long as the federal government signs off. (Schroeder, 7/10)