There’s no way to tap-dance around this one: healthcare access is an incredibly politicized and partisan issue in this country. And yet even while our two major political parties disagree vehemently, at every level, about whether existing healthcare laws are effective or worthwhile, at least one part now proving popular in a surprisingly bipartisan way.

The AP reports that Republican-led states that expanded health coverage through Medicaid aren’t necessarily in a hurry to go on and roll that back — even though that’s one of the top promises of the incoming Congress and administration.

The Affordable Care Act (ACA), both pejoratively and affectionately called Obamacare, expanded insurance coverage to millions of previously uninsured Americans. But that expansion came with challenges at every step, from getting it through Congress in the first place to a Supreme Court case that sought (and failed) to overturn it.

One big component of the ACA was the Medicaid expansion, a push to allow a higher percentage of poor and low-income adults to be able to enroll. That expansion set the universal eligibility threshold at 138% of the federal poverty level. So in 2016, for example, that cap would be at $16,394 for an individual or $33,534 for a family of four. By now, a total of 31 states have expanded Medicaid coverage, and those states have had both Republican and Democratic governors and legislatures.

But as early as 2012, two years before the ACA went into effect and four years before it would cost states any money, several states declared they would block any Medicaid expansion. A total of 26 states sued, and the Supreme Court ruled that the states could not be penalized for failing to expand Medicaid coverage. There are now 19 states that still don’t participate.

And that brings us back to the current day. When President-Elect Donald Trump takes office in January, Washington-watchers expect the ACA to be one of the very first things on the chopping block. With both houses of Congress and the White House all aligned under the Republican party, dismantling the law is indeed politically possible.

They may face challenges, however, not just from Democrats on Capitol Hill and in the states, but from members of their own party. Because in states that did expand Medicaid, leaders want to keep it.

The AP points to the example of Arizona, which despite being one of the 26 states that filed suit to block the Medicaid expansion, ended up adopting it in 2014 under then-governor Jan Brewer. Since then, nearly 400,000 Arizonans have gained health coverage through the program.

Brewer is using her political capital — she was one of Donald Trump’s early supporters — to push him to save that portion of the ACA even while he promises a major overhaul. “I don’t know how much of that, and I mean it sincerely, is going to be affected,” Brewer told the AP.

“I don’t know how you could deliver that population any more services better, more cheaply, than what we’ve already done here,” she added.

Doug Ducey, the current governor of Arizona, told the AP, “We want to see all of our citizens have access to affordable health care,” although he didn’t specify how. He signaled openness to new approaches, however, adding, “That was the objective. That’s not where we are. We’ve got a new president and a new Congress, and a fresh start.”

The office of Michigan Gov. Rick Snyder also said he planned to sing the praises of his state’s expansion to the new Trump administration. “How we continue that success is important, and he’s willing to discuss how to do that with anyone who has other ideas to consider,” a spokesman for the governor said.

Republican states that expanded Medicaid want it kept [Associated Press]

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