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Indiana, feds reach a deal on Medicaid

Those who continue to argue against Medicaid expansion out of partisan spite are facing headwinds that are only growing stronger.
A sign at an Affordable Care Act outreach event in Los Angeles, California, September 28, 2013.
A sign at an Affordable Care Act outreach event in Los Angeles, California, September 28, 2013.
Every time a Republican-run "red" state embraces Medicaid expansion through the Affordable Care Act, the pressure increases a little more on the dead-enders to come to their senses. The latest news is out of Indiana, where the Indianapolis Star reported on the agreement between Gov. Mike Pence's (R) administration and Obama administration officials.

Indiana has been given the green light to expand its Healthy Indiana Plan, which would offer insurance to an additional 350,000 Indiana residents, who currently lack insurance. The state will begin taking applications today for its so-called HIP 2.0 plan, for which coverage begins Feb. 1, Gov. Mike Pence announced Tuesday morning at a packed speech at St. Vincent Health. His announcement culminates more than two years of back and forth between state government and federal health officials over whether to grant the state a waiver for the plan debuted in 2006.

With this announcement, 28 states have accepted Medicaid expansion -- an optional part of "Obamacare" thanks to a Supreme Court ruling -- a list that includes 10 "red" states.
And these totals are growing, not shrinking.
Wyoming's efforts are advancing, as are similar efforts in Tennessee, North Carolina, and Utah.
Arkansas' Republican governor considered scrapping Medicaid expansion, but ultimately decided against it, at least for the next two years.
To be sure, the right isn't pleased with Pence extending coverage to 350,000 low-income Hoosiers, but it's simply not possible to question this governor's far-right bona fides -- Pence, a possible presidential hopeful, was a very conservative congressman and remains a very conservative state chief executive.
Then why did he accept a major component of "Obamacare"? Because the arithmetic was simply too overwhelming to ignore.
And as a consequence, other governors who are worried about appearances when it comes to Medicaid expansion have ample cover -- if Mike Pence is on board with the policy, no other state, no matter how reflexively anti-healthcare they might be, can say it's too conservative for the idea.
As we've discussed before, those who continue to argue that states should reject the policy out of partisan spite -- regardless of the benefits for families, regardless of the needs of state hospitals, regardless of the effects on state finances -- are facing headwinds that are only growing stronger.
States can only hurt themselves on purpose for so long before madness ends.