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Supreme Court ruling on Medicaid tees up campaign issue

Some Republican governors and state lawmakers are eager to opt out of the expansion of Medicaid under 'Obamacare,' now that the Supreme Court has removed the penalty. But millions could remain uninsured. Expect this to play big in some state elections.


Florida Gov. Rick Scott speaks about the supreme court's decision concerning the health care bill at a news conference on Thursday, in Tallahassee, Fla.

Steve Cannon/AP

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Just four months before Election Day, the US Supreme Court has served up a juicy campaign issue: expansion of Medicaid.

Suddenly, states now have the option of refusing to expand eligibility for Medicaid – the federal-state health-insurance program for the poor – without penalty, under the court’s health-care ruling last week. And some Republican governors are leaping at the chance to assert their opposition to Medicaid expansion, in the name of fiscal responsibility. As a result, millions of low-income Americans who would have gained health coverage now may not.

The issue is likely to play big in competitive gubernatorial elections. Ditto races for state legislatures, which will also play a role in deciding whether a state opts out of expanded Medicaid.

Leading the charge is Gov. Rick Scott (R) of Florida, who announced Sunday that his state will opt out of Medicaid expansion, which would have covered more than 950,000 people in his state. Other GOP governors pledging to ditch Medicaid expansion include Nikki Haley of South Carolina, Bobby Jindal of Louisiana, and Scott Walker of Wisconsin. Still others, like Dave Heineman of Nebraska and Chris Christie of New Jersey, say they’re leaning against expanded Medicaid.


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