At HuffPo, Ricardo Alonso-Zaldivar writes:

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 coming off as callous toward their neediest residents. 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. …

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

Conservative opponents of the health care law are leaning on lawmakers to turn down the Medicaid money. Hospitals, doctors’ groups, advocates for the poor, and some business associations are pressing them to accept it.

According to the report, “nearly 60 million low-income and disabled people” are currently covered by Medicaid, with significant differences in what that means from state to state. The number of those covered would rise by about 30 million, with the federal government paying the full cost for the first three years, “gradually phasing down to a 90 percent share.”

The Kaiser Family Foundation and the Urban Institute released findings of a recent analysis which “found that states will receive more than $9 from Washington for every $1 they spend to expand Medicaid.” Some would even come out ahead. States are conducting their own studies. Whether federal or state dollars, the bottom line, of course, will show up in individuals who will, or won’t, receive needed medical attention.

To this point, eight states “” Alabama, Georgia, Louisiana, Maine, Mississippi, Oklahoma, South Carolina, and Texas “” have declined the expansion, while thirteen, plus DC, have accepted.

Nearly 2.8 million people would remain uninsured in … [the states declining], according to Urban Institute estimates … .

(Medicaid Logo via