This week, Republican governors in both Ohio and Michigan have come out in support of expanding their state’s Medicaid programs under the Affordable Care Act (ACA). Without state participation in Medicaid expansion, the ACA’s goal of insuring the uninsured faces grave risk of failure. Despite this recent progress, there remains a great deal of uncertainty surrounding whether or not Republican governors in holdout states will support the President’s plan.  Time will tell if Ohio will serve as a predictor of state participation.

With the addition of Ohio and Michigan, 19 states and D.C. will have expanded Medicaid under the ACA, and six Republican governors have spoken out publicly in support of program expansion. In defending his decision, Ohio Governor John Kasich (R) cited that the Obama Administration was willing to compromise on certain aspects of the expansion. The Administration has been in talks with Ohio to allow Medicaid-eligible individuals, with income between 100 percent and 138 percent of the poverty line, to have the option of participating in private health exchanges.

Some holdout states remain reluctant to follow Ohio’s lead despite the Administration’s willingness to bargain. Yesterday, Pennsylvania’s Republican Governor Tom Corbett (R) expressed his unwillingness to support Medicaid expansion, citing primarily concerns about the future costs to taxpayers. Ohio is a well established bellwether in presidential elections. The success of Medicaid expansion will tell whether or not Ohio’s powers of prediction extend beyond presidential elections to presidential policies. 

This article was contributed to by Lauren Breithaupt