Now that Republicans have failed to repeal the Affordable Care Act in the short term many are still working to make the implementation even more problematic. One of the latest efforts is Paul Ryan (R-WI) “warning governors” that they shouldn’t count on generous matching funds for Medicaid expansion. From Chicago Tribune:

What makes this bill special is that Arkansas’s plans to expand Medicaid using a so-called “private option.” Instead of putting people under 138 percent of the federal poverty level on Medicaid, this would basically use the money to help this population buy private health insurance on the newly created exchange.

Arkansas is currently trying to pursue a novel path for expanding Medicaid under the Affordable Care Act. They want to take the money and instead use it to get its population to buy private insurance on the new Obamacare exchange. It has been dubbed the “Private option.”

The one big problem with this plan is that private insurance is significantly more expensive than public insurance programs.

Florida Governor Rick Scott’s decision the other day to go along with the Medicaid expansion next year, after he had previously rejected it vehemently, has been widely interpreted as simply the latest event in a series whereby Republican governors are slowly seeing the handwriting on the wall and capitulating to the hated Obamacare, while also being motivated by one political factor or another; for example, Politico lays it to Scott’s sinking poll numbers.

As part of his budget proposal Governor John Kasich (R) will support taking advantage of the Affordable Care Act to expand Medicaid in Ohio. This move comes as a bit of a surprise given that Kasich as been one of the biggest opponents of Obamacare, but in the end Kasich decided the expansion was too good a deal for the state to pass up.

Yesterday, Arizona Gov. Jan Brewer endorsed taking advantage of the Affordable Care Act to expand Medicaid to everyone up to 138% of the federal poverty level. While Brewer has been one of the most vocal opponents of “Obamacare,” in her State of the State address she acknowledged that it is the law of the land and must be dealt with as such.

When the Supreme Court declared the Medicaid expansion under the ACA optional the big question was: would any Republican dare reject such a “good deal?” Now that almost half a dozen Republican governors have publicly declared their decision not to take part, the question has instead become: will any Republican governors dare buck the party by accepting it?

Martinez is only the second GOP governor to decide to take part. The other is Nevada’s Governor Brian Sandoval who announced his intent to expand Medicaid late last year.

Idaho will not expand Medicaid under the Affordable Care Act at this time. In his state of the state address Governor C. L. “Butch” Otter said that he will not seek an expansion this year.

The Supreme Court’s decision to make the Medicaid expansion optional may have indirectly protected the program from cuts during the current fiscal cliff negotiations.

Last year the Obama administration supported the idea of reducing federal Medicaid spending by using a “blended rates” formula, but now the idea is off the table. The HHS firmly came out against the idea Monday in a Frequently Asked Question document about the Affordable Care Act.

Oh, now you tell us… or, at least Sarah Kliff of the Washington Post does: After surviving a Supreme Court decision and a presidential election, the Obama administration’s health-care law faces another challenge: a public largely unaware of major changes that will roll out in the coming months. States are rushing to decide whether to [...]