Cracks continue to develop in the Republican Partys concrete opposition to Obamacares state expansions of Medicaid, the health insurance program for the poor.
Whether those fissures will crumble Medicaid opposition in Kansas and Missouri, though, remains very much in doubt.
On Wednesday, Gov. Rick Snyder of Michigan became the sixth GOP governor out of 30 to recommend expanding Medicaid eligibility in their state.
This makes sense, he said, for the physical and fiscal health of Michigan.
And on Monday, Ohio Gov. John Kasich, another Republican, recommended Medicaid expansion in his state. An estimated 684,000 people would have new access to health coverage in Ohio, fully paid for by the federal government over the next three years, if Ohio lawmakers agree.
While those announcements appeared to weaken the GOPs rock-solid resistance to Medicaid expansion, other Republican governors and conservatives stepped up their attacks on the idea this week.
Republican Gov. Tom Corbett of Pennsylvania rejected Medicaid expansion in his state Tuesday, claiming it would be too expensive without serious reforms.
Other Republican governors Bobby Jindal of Louisiana and Rick Perry of Texas among them have also said they want to turn down the federal money for more Medicaid.
And dozens of conservative writers blasted Kasichs choice, calling it an improper, tacit endorsement of what they call Obamacare.
Governors should be working to reduce dependence on the welfare state, not add millions more to it, wrote Nina Owcharenko, a health policy analyst at the Heritage Foundation in Washington, D.C.
The governor, echoed the conservative National Review, has allowed himself to be bought off by the false promise of free money from the federal government.
The Supreme Court said last summer that expanding Medicaid under the Affordable Care Act would be optional for states. Since then, every state has wrestled with the costs and benefits of extending Medicaid eligibility for millions of Americas working and non-working poor those earning up to 133 percent of the federal poverty level.
While the first three years of expanded Medicaid will be paid for by Washington, states will eventually pick up part of the tab. By 2022, participating states must pay 10 percent of the cost of the expansion.
Expanding Medicaid is considered a key part of the health care acts goal of insuring almost all Americans. To date, roughly half of all states have indicated some support for expanding Medicaid.
The back-and-forth over the wisdom of Medicaid expansion has not gone unnoticed in Kansas and Missouri.
Gov. Jay Nixon, a Missouri Democrat, referred favorably to Kasichs decision this week while discussing his own efforts to expand Medicaid in his state. In earlier speeches, Nixon has referred to Gov. Jan Brewer of Arizona, another Republican governor who recently endorsed Medicaid expansion for her state.
Scott Rowson of the Missouri Health Advocacy Alliance said Republicans are starting to understand the cost benefits of Medicaid expansion, improving the chances for its passage in Missouri.
Were moving to a post-politics discussion, he said. Governors around the country are really looking now at what Medicaid expansion means on the ground.