This is all about looking ahead:
Analysts say if the Affordable Care Act survives to take full effect in 2014 - a major election year for governors - the hard-liners could come under fire for denying their own residents health benefits that are also worth billions of dollars to healthcare providers and insurers. The results could be dramatic."It could change the political dynamics so that the ideologues are no longer running the show," said John Holahan, director of the nonpartisan Urban Institute's Health Policy Center.
Medicaid is currently funded by federal and state governments, with Washington covering about 57 percent of the cost … benefits are available to … incomes … level of $22,300 a year for a family of four.
The Affordable Care Act would expand coverage to families with incomes of up to about $30,000. The federal government will pay 100 percent of the cost of benefits through 2016, declining to 90 percent by the end of the decade.
A much better deal for states who pay 43 percent of the cost.
Some analysts also point out that governors would turn down benefits funded by taxpayers from other states, while leaving their own residents to pay federal taxes that fund reform elsewhere. The prospect of losing billions of dollars in Medicaid payments could also anger healthcare and business interests in those states and lead them to campaign against the "rejectionists."