Indiana and Oklahoma are eyeing alternative versions of expansion and were granted a one-year reprieve by the Obama administration to extend existing state health care programs while they think about it.That leaves out the reddest of the reds—Idaho, South Dakota, Texas, Florida, and states in the deep south—in the "hell no" camp. Florida and Texas have the largest populations of uninsured, the largest populations that fall into the Medicaid gap. These states already have the high rates of poverty, great income inequality and what could be called health inequality as well.
Virginia, where Democrat Terry McAuliffe is succeeding Republican Gov. Bob McDonnell, is considered a likely candidate to embrace expansion this year. In Maine, Democrats in control of the state Legislature are pressuring Republican Gov. Paul LePage to accept the Medicaid expansion this year, during his reelection effort. New Hampshire, too, where only a Republican-led Senate has blocked expansion, is considered a likely candidate to flip this year.
Governors in small, Republican-dominated states like Wyoming, Kansas and Utah say they’re keeping an open mind in 2014, despite their hatred for the overall health law. And in every undecided state, an unusual alliance of powerful hospital, business and religious interests has been leaning on Republican leaders to reverse course.
It's one thing to talk about the statistics of the Medicaid gap, but the real story is the individual human suffering, multiplied by millions, of all those being left out. For a deep dive into what that actually looks like for the people living it, this story in The Atlantic about the Medicaid gap in Texas is a must-read. It examines the lives of real Texans trying to live with, or in one case die, with serious health issues and few places to turn. The most extreme Republicans governors and legislators are inflicting this on their own constituents, gleefully and completely needlessly.