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Associated Press

Posted on December 2, 2012 at 7:01 AM

States wary of trade-offs in accepting Medicaid expansion for millions of low-income uninsured

WASHINGTON (AP) — It's health care brinksmanship, with hundreds of billions of dollars and the well-being of millions of people at stake.

President Barack Obama's health care law expands Medicaid, the federal-state health program for low-income people, but cost-wary states must decide whether to take the deal.

Turn it down, and governors risk looking callous toward the needy. Not to mention the likely second-guessing for walking away from a pot of federal dollars estimated at nearly $1 trillion nationally over a decade.

If the Obama administration were to compromise, say by sweetening the offer to woo a reluctant state, it would face immediate demands from 49 others for similar deals that could run up the tab by tens of billions of dollars.

As state legislatures look ahead to their 2013 sessions, the calculating and the lobbying have already begun.

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