FL Gov. Rick Scott

Something remarkable happened yesterday. Florida Governor Rick Scott (R) decided to endorse using the Affordable Care Act to expand Medicaid in his state. Though he did this only after getting the administration to provide a major concession regarding how the program would be run.

This is an important policy development because it means roughly a million people in Florida could get access to health insurance. It is also a significant psychological win for the Obama administration.

There has probably been no single Republican more associated with the fight against Obamacare. Scott initial rose to prominence by personally running ads against the proposed bill and that is what helped get him elected governor. He lead the federal lawsuit against the law and after the Supreme Court ruling he was one of the first governors to come out against the Medicaid expansion. Yet now Scott has pulled a 180 and will accept the Medicaid expansion.

Republicans had two real chances to stop the ACA. The first was the Supreme Court and the second was the 2012 election. Both of these failed. Now that Obama has been re-elected and his signature law has been found constitutional, it is here to stay. It will likely be heavily altered and reformed but not completely uprooted.

Most of the Republican governors are still fighting against this reality by opposing the Medicaid expansion, but several Republican governors see the writing on the wall. Having the former biggest critic of Obamacare effectively admitting it is inevitable is a powerful turning point.

The is the biggest example so far that Republicans are slowly shifting from trying to completely kill the law to simply trying to modify it, but not the only one. Conservatives, like Douglas Holtz-Eakin and Avik Roy, have shifting away from trying to repeal the ACA to promoting reforms to make it something they can live with.