Healthy cooperation

Though most state Republican leaders vowed last year to reject the expansion of Medicaid under Obamacare, several GOP governors have made plans to increase their Medicaid rolls after all. This is very good news. Currently, many states only cover people who fall well below the federal poverty line, leaving uninsured those who are less desperately poor. Obamacare offers states funds to expand coverage to 133 percent of the poverty line—and now some Republicans have decided they can’t pass this up. Expanded coverage meets human need, they realize, and fewer uninsured people will mean fewer unpaid hospital bills and more health-care jobs.

Arkansas found its own way to like the expansion. The state asked the Obama administration for permission to buy private insurance for the targeted population instead of enrolling them in Medicaid. The administration agreed—and now other states are adopting this approach. This accommodation appeals to Republicans’ preference for relying on the private sector. It also ensures that patients will be able to keep their doctors if their incomes fluctuate, whereas under Medicaid they might go in and out of eligibility depending on income.

Private plans will likely cost taxpayers more than traditional Medicaid does. Still, wider health coverage—whether public or private—is an unquestionably positive thing. It’s encouraging to see a Democratic president and Republican state leaders work together toward a shared goal, despite their differences as to the ideal means of getting there. It’s a case of caring about results more than ideology.