“…In the aftermath of the 2012 election, it is uncertain how this process will play out, but what the states decide will play a critical role in the future of the U.S. health care system.
…More than half the governors opposing expansion predicted that the federal government would renege on the generous terms of the ACA and scale back its share of Medicaid spending. Newly elected Governor Mike Pence (R-IN) compared the expansion to “the classic gift of a baby elephant. . . . The federal government says, ‘We’ll pay for all the hay — for the first few years.’ ”
…governors expressed concern about the lack of state flexibility or their belief that Medicaid may foster dependence among beneficiaries… Others argued that Medicaid itself is the problem, calling it a “broken program”… Rick Perry (R-TX) said that adding uninsured Texans to Medicaid is “not unlike adding a thousand people to the Titanic.”
Benjamin D. Sommers, M.D., Ph.D., and Arnold M. Epstein, M.D.: “U.S. Governors and the Medicaid Expansion — No Quick Resolution in Sight”; The New England Journal of Medicine, January 16, 2013