by Brian Wolfman
As we've reported in the past (for instance, here), states with governors and/or legislatures who don't like the Affordable Care Act (ACA) have threatened not to participate in the Act's Medicaid expansion (which the Supreme Court said could not be forced on the states by Congress under the Constitution's "Spending Clause").
As from ideology, however, why shouldn't the states opt in? The federal government pays for all the expanded Medicaid benefits for the expansion's first two years and for at least 90% after that. And the ACA's Medicaid expansion is large, guaranteeing health insurance to nearly everyone with incomes up to 133% of the federal poverty level and, assuming full participation, adding about 21 million currently uninsured people nationwide to the Medicaid program.
And as it turns out, though many states are still refusing to participate, the trend is toward participation. As Sarah Kliff reports, a majority of the states have now agreed to the expansion. That includes Pennsylvania and its Republican Governor Tom Corbett. And Michigan's Republican governor, Rick Snyder, just signed Medicaid expansion legislation. And, back in February, even Florida Governor Rick Scott, an ardent ACA opponent, changed his mind and signed on to the expansion.
Watch for the trend to continue. Even some Obamacare haters know a good deal for their citizenries when they see it.