But I think in general states are going to have to accept the federal dollars to expand Medicaid. It is the law of the land for better or worse and to say no to tax dollars that already being collected and not use them is a waste at any level.
Is this how entitlements are created? You bet. Will Medicaid be faced with cost overruns and shortages of care and other bad stuff? No doubt. I could write the articles now and just add the numbers in later. It will be up to those of us who would rather see a more rational market for medicine to change how dollars are spent. To tell governors NOT to use Medicaid money to expand healthcare is like telling students not to get student loans for college. Few of us have the income to match the courage of that conviction. And any politician who does not take money to cover a new benefit is probably a politician that will not be re-elected. People forget that Reagan expanded Medicaid coverage in California.
From here on in -- or until there is one party Republican government -- Obamacare will be the law of the land. The binary decision has been made. The issues are no longer a matter of yes or no as much as they are "how much?" and "how?"
That's governing. As James Madison wrote in the Federalist Papers: "in framing a government which is to be administered by men over men, the great difficulty lies in this: you must first enable the government to control the governed; and in the next place oblige it to control itself."
Somethings never change.