New Hampshire, a state that was noncommittal on Medicaid expansion, is now on the brink of expanding coverage to approximately 50,000 poor residents. The Republican-controlled Senate voted to pass a state-modified version of expansion earlier this month. And, on Tuesday, a House panel endorsed the motion. The Democratic-controlled House is expected to pass the bill in a vote next week.

In Virginia, Democratic Governor Terry McAuliffe has been fighting for Medicaid expansion since he was elected in November (the Republican-led House is opposed). Tensions came to a head this weekend when several hundred demonstrators gathered outside the state capitol in Richmond to rally for Medicaid expansion, carrying signs that read "We need Medicaid expansion now" and "Get sick, go broke, unacceptable!"

In Pennsylvania, Republican Governor Tom Corbett had originally proposed a modified version of the program, tying in a controversial requirement that mandated those working fewer than 20 hours per week participate in a job-training program to qualify for coverage. The governor has since submitted a softer proposal that "restores some benefits" and drops the work-search requirement in favor of a voluntary pilot program. That plan, currently under review by the federal government, is unlikely to win support from Washington, given Corbett's stipulations.

Representatives for Utah Governor Gary Herbert traveled to D.C. this week to discuss Medicaid expansion efforts with administration officials. The governor, who initially refrained from opting in, in January vowed to take action on Medicaid expansion, saying while he opposes President Obama's health care law, the state has an obligation to help its poor. But his proposal, a "block grant" option that would use federal dollars to cover the poor in private plans, failed to win the support of Republican leaders in the House and Senate. The Salt Lake Tribune reports that "though he lacks the backing of the Legislature, lawmakers haven't tied his hands." Herbert advisers meeting with the Obama administration this week include Wesley Smith, director of state and federal relations; David Patton, head of the state's Department of Health; and staff members from the Health Department's Medicaid office, according to the Deseret News.

Movement in Missouri has been stymied by a standoff between Democratic Governor Jay Nixon, an advocate of expansion, and the state's GOP Legislature. But even there, the dynamic is starting to shift. KCUR.org reported Tuesday that Missouri politicians "might be inching toward middle ground that would expand Medicaid eligibility while reforming the safety-net program to encourage recipients to work," according to two key participants in the talks. Legislation pending in the House is scheduled for a hearing on on March 25.