When the US Supreme Court ruled last year that president Obama’s health care plan (known officially as the Affordable Care Act and popularly as Obamacare) was constitutional, Republicans and Tea Party activists were surprised and livid because they had been confident that the law would be overturned.

However they took some small comfort from the fact that the court ruled that the government could not force states to accept the Medicaid expansion provision that would have made a larger number of poor people eligible for it. Republican governors of states vowed to reject the expansion, even though the federal government would provide almost all the funding for it at least in the first few years. But the governors were not forced to actually do anything initially because anti-Obamacare activists pinned their hopes on Mitt Romney being elected president and rolling back the health care reforms.

However, that hope was also dashed and Republican governors were now forced to make a decision and it turns out while 15 have carried out their threat to reject the expansion, six (including Ohio) have decided that they should accept it and nine are still undecided. This has caused considerable rumbling within the party and the activists who feel betrayed by these Republican governors

There is still time for governors to change their minds either way, though the changes are likely to be those in favor of acceptance since there are powerful state medical lobbies that want the states to accept the federal dollars. So both those who accepted it and those who rejected it are under pressure from different interests.

So what seemed like an easy decision ideologically turned out to be difficult to implement when they were actually confronted with doing something. The governors must be regretting the partial ‘victory’ that the Supreme Court supposedly gave them.