MONTANA: It's official: ACA Medicaid expansion signed into law

And Then There Were 21:

Democratic Gov. Steve Bullock signed the Montana Health and Economic Livelihood Partnership (HELP) Act into law Wednesday in the Capitol rotunda as hundreds of people cheered.

The bill was introduced by Republican Sen. Ed Buttrey of Great Falls after lawmakers defeated the governor's expansion proposal.

Buttrey calls the plan the most conservative in the nation due to copays, premiums and other provisions. Because of those items, the state must seek a waiver from the federal government to put the program in place.

Assuming the vast majority of those eligible enroll (which seems to be the case in most states which have gone through with expansion to date), we should be able to chalk up another 35,000 - 70,000 Medicaid expansion enrollees over the rest of the year.

That leaves 21 states being curmudgeons about going through with Medicaid expansion, of which 4 are at least discussing the possibility. All told, these 21 states are leaving about 3.7 million people stuck in the Medicaid Gap for no particularly good reason:

Under Discussion:

• Alaska (10.5K people): Governor pushing for it, Legislature opposed
• Florida (669K people): Governor opposed, Legislature tearing itself apart over it
• Missouri (147K people): Governor pushing for it, Legislature opposed
• Utah (30K people): Governor pushing for "private option" version; Legislature opposed

Still No Dice:

• Alabama (176K)
• Georgia (282K)
• Idaho (51K)
• Kansas (60K)
• Louisiana (166K)
• Maine (22K)
• Mississippi (107K)
• Nebraska (31K)
• North Carolina (357K)
• Oklahoma (104K)
• South Carolina (178K)
• South Dakota (a few thousand?)
• Tennessee (142K)
• Texas (948K)
• Virginia (171K)
• Wisconsin (special case)
• Wyoming (14K)