Politico writes in some depth about the shift in Republican leadership thinking — with some mostly Deep South exceptions — in favor of accepting the medical coverage expansion provided by Obamacare, but shaping it in ways more palatable to conservative thinking. Privatizing is the ultimate aim (and, in time, lopping the reviled "takers" off the rolls of people helped by taxpayers, but that's a future story).
The article talks repeatedly of how the hybrid Medicaid expansion under consideration in Arkansas is influencing other states. Not much mention in this particular article is given, however, to how iffy that expansion remains, given the difficulty of passing spending bills in Arkansas (75 percent approval) and the hard line taken by a significant number of Tea Party-style Republican legislators here. Excerpt:
The state’s Democratic governor, Mike Beebe, wants to expand Medicaid. His Republican Legislature did not. The compromise: Instead of boosting Arkansas’s existing Medicaid rolls, the state has pitched using Medicaid dollars to buy the low-income population private health coverage through the Obamacare exchange. The Obama administration is cheering on the proposal, though details need to be ironed out.
“The plot twist is that some people have figured out what they think is a way to have both, to help their people in a way that is consistent with what they see as their political principles and their political future,” said Stan Dorn, a Medicaid expert at the Urban Institute, of the wave of governors with second thoughts. “Privatization of Medicaid could provide a way to give the people of your state and the people of your district the practical benefits of Medicaid expansion while avoiding the political damage.”