30 states plus DC have already expanded the program as the law intended. Those who refused expansion have done so after a 2012 Supreme Court case gave Republicans an out. This has caused a lot of confused uninsured in the “Medicaid gap” to blame Obama(care) for their lack of insurance. One could argue this was the plan of the GOP, but finger pointing and politics plays a distant second to ensuring coverage for almost 5 million who have no insurance options due to the rejection of expansion.
States can draw up their own Medicaid expansion alternatives like Daugaard. Daugaard rejected the expansion three years ago, objecting to allowing “able-bodied” people to get covered. However, his recent support is encouraging. It should be clear that a plan to expand and actually expanded are two different things. The Federal Government has given South Dakota the thumbs up, but other states who have contemplated expansion and been approved, like Tennessee, ended up rejecting the measure on a state level.