The funny thing about Medicaid expansion is that it is like endless soup — that recipe where tomorrow you take on yesterday's leftovers, build in a few new ingredients, and serve it up. Don't like today's soup? You could always hold out for tomorrow's. By this, I mean that optional Medicaid expansion under the ACA is never a yes or no thing, only a "not now" or "not on those terms" thing. And so it has always been with Medicaid state buy-in since its very inception and so it is, I would argue, with American-style health care reform. We are rarely all in or all out.
That's what I say when people ask me about the Missouri legislature's apparent failure to address ACA optional Medicaid expansion this session.
Anybody for yesterday's soup?