In the last four years, we've seen a lot of reflexive, frankly dickish anti-Obamaism from Republicans at all levels. Much of it is relatively harmless; when some knuckle-dragging congressman goes on talk radio to air his suspicions that Obama's birth certificate is a forgery, there may be some chipping away at the President's legitimacy, but no one's life is affected directly. But there are some cases where Republicans are willing to do direct, substantial, even life-threatening harm to thousands or even millions of people, for literally no other reason than to demonstrate their unflagging hatred for the man in the Oval Office.
I'm talking here about the coming expansion of Medicaid, which didn't get discussed much during the campaign, but which is the most profound effect of the passage of the Affordable Care Act. As you'll recall, when the Supreme Court upheld the individual mandate, it gave a gift to Republicans too, saying states could opt out of the law's expansion of Medicaid, under which anyone earning up to 133 percent of the federal poverty level would be eligible. Especially for poorer, Southern states, the Medicaid expansion is a huge boon, particularly since the federal government will be paying all the cost of the expansion in the first few years, and nearly all the cost from that point forward. Those states currently have absurdly stingy eligibility requirements for the program, making it so that if you earn enough to live someplace other than your car and eat as much as two meals a day, you're probably ineligible. So here comes the federal government, saying to the states, "We're going to pay to get all these poor people in your state health insurance, which will save the state money in uncompensated care, and make for a healthier, happier, and more productive population." To which many states have replied, "Screw you, Obama!"