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.