Heritage’s Stuart Butler, director of the Center for Policy Innovation, wrote at the JAMA Forum yesterday on the Obama Administration’s push for states to participate in the expansion of Medicaid. Here’s an excerpt from Butler’s piece:

Even after the Supreme Court struck down a requirement of the Affordable Care Act (ACA) that required states to expand Medicaid coverage to low-income individuals,* states still seemed to have a juicy carrot to do so. That’s because 100% of the extra cost for states will be met by Uncle Sam for the first 3 years, starting in 2014. And although the federal share of costs for these newly covered individuals will gradually decrease thereafter to 90%, that is still a much bigger share than for “regular” Medicaid.

Not surprisingly, the Obama Administration is pressing states to see this as a deal that no sensible governor and state legislature can refuse and to think that doing so would harm the state and its clinicians and health care facilities. And even some Republican governors, such as Rick Scott of Florida, say there is no sense in leaving federal money on the table. Still, others are balking, such as Louisiana’s Bobby Jindal. Are they lacking common sense?

It turns out that the picture is not so simple.

Read the whole article at the JAMA Forum.