State & Local Government Policy, Business and Technology

Pass. Repeal. Repeat: The GOP Cycle of Defying Voters on Health Care

Governing: In the first several years after the Affordable Care Act (ACA) helped states make more low-income people eligible for Medicaid, it was only Democratic-led states that took the federal government up on its offer. Republicans have since warmed to the idea -- but only on their own terms, and sometimes even if it means going against voters' wishes.

“It’s not tenable anymore to just say no. [Republicans] are feeling pressure to come up with something, but that something they want is a tool to change the way the Medicaid program works,” says Joan Alker, executive director of the Georgetown Center for Children and Families, which studies Medicaid, the nation's government-run health insurance for the poor.

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