One of the most conservative Southern senators now supports expanding Medicaid

Louisiana Senator David Vitter, a Republican and 2015 gubernatorial candidate, said he's open to expanding the public health-care program Medicaid through Obamacare, the Associated Press reports.

"We need to improve and reform Medicaid, and I want to look at everything that could be brought to bear to do that"

The announcement increases the chances that Louisiana will become one of the next Republican states to adopt the Medicaid expansion. Current Governor Bobby Jindal, who's term-locked from running for re-election, is one of the expansion's staunchest opponents in the ongoing battle over the Medicaid expansion.

Vitter, a major critic of the health-care law, reportedly told the Press Club of Baton Rouge that the expansion could be used to reform a health-care program he views as broken.

"We need to improve and reform Medicaid, and I want to look at everything that could be brought to bear to do that," he said. "Now, could more federal resources help to do that? They could, if it's done right and if it's done in a constructive way."

Republicans have found they have a good deal of leverage in using the Medicaid expansion to request state-based reforms, which require a federal waiver, from the expansion-supporting Obama administration. Arkansas pioneered the unique approach with a private option that uses Medicaid dollars to enroll people into private insurance plans through HealthCare.gov. Since then, Michigan, Iowa, Indiana, and New Hampshire have adopted their own reform-pegged expansions.

Whether Vitter actually becomes governor and manages to expand Medicaid is, of course, an open question. But at the very least his current support for a reform-based expansion shows the growing schism among Republicans about whether they should approve the Medicaid expansion.

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