So far 21 states, fortunately NOT including West Virginia, have pledged not to expand Medicaid health coverage to low income working adults under the Affordable Care Act. I suppose all kinds of justifications can be given but I think it boils down to spite. And to contempt for poor people. And because some people can't stand the idea of a black man in the White House. Or some combination thereof.
Whatever may be the case, and, yes, I know I was being snarky, spite is expensive. According to a new Kaiser/Urban report, nearly two-thirds of those who would have benefited from the expansion live in state states that have either refused it or have not yet decided. This means 6.4 million Americans going without health care unnecessarily. Those states are also giving up over $50 billion federal dollars in 2016 alone. Go figure.
More links and facts here.