We keep hearing about states that may opt out of the ObamaCare Medicaid expansion. But there’s a strong argument that states headed up by even the most dogmatic opponents of reform–like Gov. Rick Perry’s Texas–will end up opting in.
As Jay Hancock of Kaiser Health News notes (and I agree), “Insurers are expected to join hospitals and patient advocates to fight for Medicaid expansion and what are enormous amounts of money.” He adds, “If there’s one thing more powerful than Republican governors’ dislike of the Affordable Care Act…it may turn out to be the business interests in their own states.”
I also sincerely believe that public pressure to help millions of poor people will simply force the hands of the Rick Perrys of the world. Call it the “better angels of our nature” argument. As Jonathan Cohn says, “I remain convinced that most states will choose to participate in the Medicaid expansion before January 1, 2014, and that the holdouts will come within a few years after that. But I’m confident of that only because I’m confident that politicians will feel political pressure to do so—and progressives must do their part to create it.”