My whole point about the Medicaid expansion and the inevitability of Republican governors opting out at the outset is that those who support the expansion cannot take such a lackadaisical attitude about it. This is not a situation that will just change over time without a major challenge, pressuring these right-wing officials with the consequences of their inaction. You need to make the moral argument that we’re not a country that allows people to die in the streets because they cannot afford medical care.

It’s going to take that kind of effort in Florida to force Rick Scott against his will to expand Medicaid, or to kick him out of office and have his successor do it. And that includes all levels. This statement from the likely challenger to Scott is telling:

A battle is brewing here in Florida, where Gov. Rick Scott took to national television soon after the ruling to announce that he would reject the expansion. Advocates for the poor and some players in the health care industry — especially hospitals, a powerful political lobby — intend to push back [...]

But there is noticeable frustration with the White House from some. State Senator Nan Rich, a Democrat running for governor in 2014, said the administration needed to do a better job of countering state-level opposition.

“The Obama administration needs to be more forceful in going out there and explaining what is true and what’s not,” she said.

I think the media narrative from liberal wonks resting on their laurels and assuming that Republican governors will take the “great deal” has seeped into the White House’s thinking. That’s not going to get it done. I understand that the political dynamic will shift depending on who wins the election, so it perhaps makes sense to wait until then. But it would help for someone, say Alan Grayson of Florida for example, to make these kinds of arguments as well, just to reiterate what’s at stake.

Republican Governors are engaging in a sadistic form of public policy making by denying these people their care.

This is what you need to address to both Republican and also Democratic governors. There are the cold, wonkish arguments – denying care increases public health emergencies and the cost of uncompensated care, states will make out better than advertised because of the stimulative properties of federal Medicaid support, etc – and then there are the arguments that point the finger at human cruelty. You need them both.