Governors who refuse to expand Medicaid are doing so for political reasons, despite the needs of their state’s citizenry

One of the key provisions of the Patient Protection and Affordable Care Act, or ‘Obamacare’ was the expansion of Medicaid program across the states. The Supreme Court struck down the requirement for states to expand the program in 2012, and 20 states have since opted out. In new research, Charles Barrilleaux and Carlisle Rainey look at why state government have opted out of the Medicaid expansion. They find that political variables, such as Obama’s 2012 vote share and the governor’s partisanship are the best predictors of opposition to Medicaid expansion, rather than measures of need, such as life expectancy or the number of people that are uninsured.