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January 28, 2015 at 07:05 AM
(Bloomberg View) — Big news on Obamacare today — and perhaps for the 2016 fight for the Republican presidential nomination as well.
Gov. Mike Pence of Indiana has reached an agreement with the federal government to accept expanded Medicaid for the Patient Protection and Affordable Care Act (ACA), even while radically changing the state’s regular Medicaid system.
See also: Indiana wins approval to expand Medicaid.
It’s a huge deal because it’s another sign that the U.S. Supreme Court has only delayed the Medicaid expansion required under the law rather than preventing it altogether. If even a conservative firebrand such as Pence can’t hold out, it’s increasingly clear that the federal incentives for state governments to sign on are just too strong to resist. In Arkansas, new Republican Gov. Asa Hutchinson is asking the legislature to keep the state’s “private option” for the ACA’s Medicaid expansion, a compromise championed by his Democratic predecessor.
Overall, it’s now possible that despite last year’s Republican landslide, no state will roll back its coverage while a handful of holdout states will add it.
This doesn’t mean the law’s Medicaid expansion is anywhere close to a done deal nationally. But as long as it continues to be a one-way street, full compliance is only a matter of time, even if it takes a decade or so to get there. This is likely to accelerate once Barack Obama leaves the White House.
