Kansas Republicans have stood fervently in opposition to ACA and Medicaid Expansion. In a floor speech during the tax debate, Mary Pilcher-Cook (R-Johnson County) referred to Medicaid expansion as "evil," and during a conference committee handed out leaflets noting the "evils of Obamacare" as a reason to look at charging insurance providers a fee in the state of Kansas.

Gov. Bill Haslam is calling a special session of the legislature to hear his answer to Medicaid expansion: "Insure Tennessee," a two-year pilot program that would provide health care to more than 200,000 Tennesseans who lack direct access to coverage.

Several Republican governors are considering implementing, or have implemented, ObamaCare’s Medicaid expansion in their states. Indiana’s Mike Pence is the latest, announcing a new deal this week that abandons conservative principles by adding 400,000 able-bodied adults to the Medicaid rolls, costing taxpayers $3 billion a year.

Despite the widespread success of the Affordable Care Act in signing up the uninsured, a few stubborn states that refuse to expand Medicaid house large populations of African Americans.