It's a hot issue because Obamacare allows states to expand their pool of eligible Medicaid recipients. For the first three years, Washington promises to pay 100 percent of the freight for new enrollees; later, federal support would shrink to 90 percent. (Washington covers about half the cost of today's pre-ACA enrollees.)
It's as free as free money gets in this country -- nearly $1 trillion over 10 years, which leaves Republican governors with a dilemma. To snatch or to spurn, that is the question.
More than 20 states with a Republican governor or legislature have refused the new Medicaid scheme. Texas Gov. Rick Perry and Louisiana Gov. Bobby Jindal lead the pack of GOP guvs who have said no. Jindal said the so-called free Medicaid money "would cost Louisiana taxpayers up to $1.7 billion over the next 10 years and move nearly 250,000 Louisianans from private coverage to Medicaid."
Last week, the Club for Growth called out an Idaho congressman for accepting the endorsement of an industry group that supports Medicaid expansion in Idaho. Club spokesman Barney Keller told me the issue isn't exactly a litmus test, but "anyone who thinks that the feds are going to make good on their promises to pay for the Medicaid expansion" is kidding himself.
This month, Sen. Rand Paul, R-Ky., told Fox News that New Jersey Gov. Chris Christie could be sorry the Garden State is expanding Medicaid under Obamacare. "I don't think that is going to resonate in the Republican primary," quoth Paul, who himself seems eager to run in 2016.
Christie is in good company. Other GOP governors -- John Kasich of Ohio, Jan Brewer of Arizona and Rick Scott of Florida -- are taking advantage of the Obamacare Medicaid terms.
Sparring with Laura Ingraham on Fox News Channel, Kasich gave an impassioned defense of his decision. It's his job to "bring Ohio money back to Ohio," Kasich said. His constituents pay federal taxes; if he says no to Obamacare dollars, "they're not going to put (the money) in a piggy bank."
And: "It's not like it's cost-free to turn this down."
Kasich played up his brand of compassionate conservatism: "Conservatism means that you help people so they can help themselves and that they can enter into the economic strength of our country." After Kasich went around Ohio's GOP Legislature to add 275,000 to his state's Medicaid rolls, his anemic poll numbers increased.