Rejecting the Medicaid expansion in the federal healthcare law could have unexpected consequences for states where Republican lawmakers remain steadfastly opposed to what they scorn as "Obamacare."
It could mean exposing businesses to Internal Revenue Service penalties and leaving low-income citizens unable to afford coverage even as legal immigrants get financial aid for their premiums. For the poorest people, it could virtually guarantee that they will remain uninsured and dependent on the emergency room at local hospitals that already face federal cutbacks.
Concern about such consequences helped forge a deal in Arkansas last week. The Republican-controlled Legislature endorsed a plan by Democratic Gov. Mike Beebe (pictured) to accept additional Medicaid money under the federal law, but to use the new dollars to buy private insurance for eligible residents.
One of the main arguments for the private option was that it would help businesses avoid tax penalties.