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President Joe Biden has an unexpected opening to cut deals with red states to expand Medicaid, raising the prospect that the new administration could extend health protections to millions of uninsured Americans and reach a goal that has eluded Democrats for a decade. The opportunity emerges as the COVID-19 pandemic saps state budgets and strains safety nets. That may help break the Medicaid deadlock in some of the 12 states that have rejected federal funding made available by the Affordable Care Act, according to health officials, patient advocates and political observers. Any breakthrough would require a delicate political balancing act. New Medicaid compromises could leave some states with safety net programs that, while covering more people, don’t insure as many as Democrats would like. Any expansion deals also would need to allow Republican state officials to tell their constituents they didn’t simply accept the 2010 health law, often called Obamacare.

United statesNorth carolinaSouth dakotaSouth carolinaUniversity of alabamaCindy mannChris jenningsBarack obamaDavid beckerJoe bidenKelly hallPhelps phillipsMatt saloLaura kellyBill mcinturffTexas academy of family physicians