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.

If you haven't been worn down reading about Todd Akin's bizarre and ignorant views about the female reproductive system, now turn to Texas, where women's uteruses may soon have to move out of state to find health care. Late Tuesday night, a federal court of appeals ruled that Texas can exclude Planned Parenthood from the Women's Health Program, which provides basic preventative care—like birth control and cancer screenings—for low-income women. The decision has terrifying implications in a state where women's access to health care is already poor.

Republicans' pleasure over Mitt Romney picking Paul Ryan for his running mate is tempered by their nervousness that Democrats will use Ryan's budget to hammer them on Medicare, particularly in Florida. And yes, they will. So how are Republicans going to respond? The answer is that they'll employ the time-honored "I know you are, but what am I?" strategy.

The National Republican Congressional Committee, the House Republicans' campaign arm, is sending out memos to its members telling them to, in the title of one, "Stay on offense on Medicare." And how do you do it? You say, we're not the ones who want to destroy Medicare, the Democrats are the ones who want to destroy Medicare! We're already hearing it from Romney and Ryan, and it'll be coming from all kinds of other places as well; here's the Heritage Foundation saying "Obamacare ends Medicare as we know it." (How? Because it's all governmenty.)

This kind of muddying of the waters has worked before...

Welfare systems exist to reduce the worst excesses of poverty. When poverty increases during recessions, the welfare state is supposed to rush into countercyclical action, providing a firewall against a growth in destitution.

That’s the theory, anyway. In practice, it’s never been the case. In recent years in particular, the American welfare system has increasingly shed itself of this key obligation.

Texas has a higher proportion of its population living without health insurance than any other state. But like many other states with lots of poor people, it has the misfortune of being governed by Republicans, which explains why yesterday, Governor Rick Perry announced that the state will refuse to accept the money the federal government is offering to expand Medicaid eligibility to everyone who makes up to 133 percent of the federal poverty level. Perry says that this expansion of Medicaid, which is almost entirely paid for by the federal government, will nevertheless bankrupt the state and put the oppressive boot on the necks of Texans. So he's happy to keep 25 percent of his population uninsured.

In case you're wondering, Texas currently sets eligibility for Medicaid at 26 percent of the federal poverty level, which means that if you earn more than $6,000 a year for a family of four, you're not eligible. That's not a typo. Six thousand dollars a year for a family of four is what the state of Texas considers too rich to get on Medicaid. Look down the list of eligibility levels, and you find that only Alabama, Arkansas, Indiana, and Louisiana set their eligibility lower. It is just so weird how those poor Southern states are the stingiest with health care benefits, isn't it?

It's possible that eventually, Texas and the other states will come around to the expansion of Medicaid. Sarah Kliff explains how this happened with Medicaid's enactment in the 1960s and the Children's Health Insurance Program (CHIP) in the 1990s; conservatives initially resisted, but the money and the opportunity to insure their population eventually became irresistable. One of the key factors then and now is the presence of organized, influential interest groups—particularly the hospitals that have to deliver uncompensated care to the uninsured, costing them billions—that can exert their influence on the government's decisions.

But the Republicans who resisted and then gave in were different from the Republicans of today, and this will be a test of just how far they'll go to make a statement about their hatred of the federal government in general and their hatred of Barack Obama in particular. Today's Republicans are the ones who would turn down a deal offering ten dollars of spending cuts for one dollar of tax increases. But that was a hypothetical question, and this question is very real. There are actual human beings whose lives are at stake. I'd love to hear someone ask Rick Perry this question: Which do you think is worse, someone living without health insurance, or someone getting health insurance through a government program? I'm not sure what he'd say, but his actions say quite clearly that he'd prefer that the person have no health insurance. Of course, we're not talking about him personally, or his kids, or anybody he knows having to go without insurance. We're talking about poor people. So screw them.

It's a well-known rule in journalism that when you don't want to write the story your editor assigned you, you suggest a new one—an equally good, if not better, alternative.

It's no secret there's a health-care crisis in Texas. The state has the biggest uninsured population in the country with around 6.2 million—or a quarter of all residents—lacking insurance. As a Kaiser Health News report highlighted, poor and uninsured Texans must sometimes wait more than 24 hours in emergency rooms, where treatment is most expensive, while more cost-effective health-care options, like preventative care, are out of reach.