Crafting a Narrative for the Red State Option

60 Pages Posted: 21 Sep 2013 Last revised: 2 Oct 2015

See all articles by Elizabeth Weeks

Elizabeth Weeks

University of Georgia School of Law

Date Written: September 20, 2013


This Article examines the current state of play following the Supreme Court's decision in NFIB v. Sebelius to allow states the option of expanding their Medicaid programs in accordance with the Patient Protection and Affordable Care Act (ACA). Holding that mandatory expansion was unconstitutionally coercive, the Court created the Red State Option. Despite the enormously generous federal financial support for Medicaid expansion, close to half of the states have declined. At the same time, at least eight Republican-led states have crossed Tea Party lines to accept federal funding for expansion. Drawing lessons from these states, including Arkansas, Arizona, Michigan, and Florida, the Article articulates key elements of a Red State Narrative that would allow other reluctant states to come around to expansion without losing political face.

Keywords: Health Care Law, Health Reform, Affordable Care Act, Obamacare, Federalism, Medicaid

JEL Classification: I1, I38, K32, J18, H51, H55

Suggested Citation

Leonard, Elizabeth, Crafting a Narrative for the Red State Option (September 20, 2013). 102 Kentucky Law Journal 381 (2013 - 2014); UGA Legal Studies Research Paper No. 2015-25. Available at SSRN:

Elizabeth Leonard (Contact Author)

University of Georgia School of Law ( email )

225 Herty Drive
Athens, GA 30602
United States


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