As they make a series of changes — through waivers and other means — to swing the programs to the right, [GOP governors] are building a broader political base for the programs in red states. That could make ACA repeal and Medicaid cuts an even tougher sell in the future than it is now. …
Idaho is one flashpoint, where the state has tried to permit insurers to offer skimpier but cheaper non-ACA compliant plans to the healthy that could push up premiums for sicker people. The federal government has stopped the state from moving ahead, while leaving the door open for it to accomplish its aims in a different way.
Kentucky has been another hot zone, as the state is being sued to block its Medicaid work requirement approved under a new waiver.
Indiana and Arkansas are two other states with controversial waiver provisions.
Waivers themselves are under fire. They are supposed to be used for research and demonstration purposes, but administrations have long pushed the boundaries of waiver authority to pursue their own policy goals.