My problem with Obamacare

[ProSense]

32. That's

"So we will have a two tiered country

progressive Blue States with SP and regressive Red States without even Medicaid expansion and doing whatever they can to stop the ACA."

...what happens until the Republicans come around. Look at marriage equality.

It took Arizona nearly 20 years to join Medicaid.

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Medicaid got a chilly reception when it launched in January 1966. It was up to the states to decide whether to participate and only six initially signed up: Hawaii, Illinois, Minnesota, North Dakota, Oklahoma and Pennsylvania. Twenty-seven followed suit later that year. Across the country, governors weighed the boon of new federal dollars — Washington would foot half of Medicaid’s bill — against the drawback of putting state money into a new program.

Nascent Medicaid programs quickly faced threats: Republican legislators in the New York introduced a bill in 1967 calling for the state to “live within its means” and repeal its Medicaid program.

Doctors, meanwhile, lamented the program's bureaucracy and griped that payments often arrived late. "Doctors' complaints tie up our telephone lines all day, every day," Frederick W. Richmond, chairman of the Citizen's Committee for Medicaid, told the New York Times in 1967. Some pharmacists voted to boycott the program altogether.

Over time, however, the lure of federal dollars proved strong enough to win over resistant states. Eleven joined the program in 1967. Another wave of eight, largely Southern states came on board in 1970. Arizona proved the last holdout, not joining Medicaid until 1982.

<...>

http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/07/09/six-governors-say-they-will-opt-out-of-medicaid-how-long-will-they-hold-out/

Single payer is going to come state by state.