Florida governor Rick Scott, with his skeletal frame, shiny bald pate, 9-figure fortune possibly obtained at least partially through Medicare fraud, and love of humiliating poor people, resembles nothing so much as a comic-book villain. So it was something of a surprise when he announced yesterday that he is reversing his previous position and will allow poor Floridians to receive Medicaid coverage as provided for in the Affordable Care Act. It isn't hard to explain why: the federal government is paying 100 percent of the cost of new enrollees in the first few years, and nearly all the cost thereafter, meaning for a small investment on the state's part it gets a healthier, happier, more productive citizenry. Only a truly despicable politician would turn it down, preferring to see their constituents go without health insurance than get it from the government, as I've argued (OK, "raged" is more like it) before.

After the Supreme Court said it its Obamacare decision that states could opt out of the Medicaid expansion, some people were more optimistic than I was, arguing that though Republican governors might shake their fist at Barack Obama for a while, eventually the Medicaid money would be too difficult to turn down. It's looking like I was wrong and they were right; Scott follows Republican governors in states like Ohio and Michigan in announcing that they'll accept the expansion, and though there are still some holdouts (most notably Rick Perry of Texas, which has more uninsured than any other state), the dominoes are starting to fall.

So what does this tell us? It turns out that even the most ideological politicians respond rationally to the incentives they're presented with—maybe not all the time, but much of the time.

Last year, as part of implementation for the Affordable Care Act, the Obama administration rolled out a rule on contraception that inspired a huge backlash from religious conservatives and began the “war on women” fight that extended through the presidential campaign. In short, Health and Human Services required all employers to include contraception in health insurance plans, without extra charge. Religious institutions could receive an exemption as long as they met particular requirements: Said organizations had to be nonprofits who mainly employed co-religionists, and had “the inculcation of religious values” as their primary purpose.

In the 40 years since Roe v. Wade, quite a bit has changed about the abortion debate. Evangelicals have taken the helm of the anti-choice movement, once dominated by Catholics. The movement has shifted strategies repeatedly—from stoking moral outrage and blocking abortion clinics to feigning concern for women’s health and, most recently, passing innocuous-sounding building regulations aimed at eliminating access to abortion.

Since the ruling was handed down 40 years ago today, Roe v. Wade—which held that the constitutionally guaranteed right to privacy included a woman's right to choose to have an abortion—has been subject to an ongoing legal and political assault. This assault has not succeeded in getting the decision overturned. But it has caused the scope of the opinion to become narrower in ways that have disproportionately affected the rights of women of color, poor women, and women in isolated, rural areas. The re-election of Barack Obama might make Roe safe for the time being, but it is worth taking stock of how its meaning is being eroded and what the future battles would be.

As a rule, most merger or affiliation announcements between two organizations tend to the celebratory: Each group brings a proud history and now have joined together to create an even prouder future, yadda yadda. But not last Thursday’s press release from the California Nurses Association/National Nurses United (CNA), which proclaimed its affiliation with the National Union of Healthcare Workers (NUHW) in an announcement largely devoted to attacking the presumed perfidy of the Service Employees International Union, with which NUHW has been engaged in a prolonged blood feud that puts the Hatfields and McCoys to shame.

There have been few more consequential years in the history of health care in America than 2012. This year saw disasters averted, new problems identified, and hope triumphing over despair. The biggest health-care news in 2012 was the dramatic and surprising decision by the Supreme Court in late June to uphold (for the most part) the Affordable Care Act (ACA). Chief Justice John Roberts shocked his Republican admirers by siding with the liberals on the Court to affirm the constitutionality of the law's individual mandate as a tax, though he also gave Republicans a way to fight back by saying the federal government couldn't force states to accept what is arguably the law's most significant feature: its dramatic expansion of Medicaid.