About 3,000 more Vermonters will be eligible for Medicaid coverage beginning in 2014 .

And 1.8 million additional Texans could receive the same benefit, but probably won’t.

Why? Politics, of course.

As a part of the Affordable Care Act, federal government will pay for nearly all the costs of expanding each state’s Medicaid program to cover the uninsured. The Kaiser Family Foundation predicts that 21.3 million Americans would be covered by Medicaid by 2022, if all the states accept the expansion.

But thanks to the Supreme Court, states have the option of turning down the expansion.

Nine have said no. Seventeen have said yes. As you probably guessed, all the states that have said yes are Democratic and the states that have said no swing the other way.

A few Republicans are trying to buck their party to cover the insured but the issue has become another Republican litmus test, where loyalty to the party is more important than accepting federal aid that will literally save lives.

About 26,000 Americans die each year for lack of insurance. Hundreds of thousands more go bankrupt because they cannot afford their medical bills.

The problem is that the states that are currently most desperately in need of Medicaid expansion are also run by Republicans. Take a look at the map below. The darker the state, the higher the number of the uninsured.

By rejecting Medicaid expansion, state Republicans are sabotaging the effectiveness of the program and passing the costs on to taxpayers who will still have to absorb the costs when the uninsured cannot pay their emergency room bills or end up on Medicare or Medicaid in ill health.

Many red states also lead the nation in obesity, the nation’s leading preventable health care cost.

Democratic states have long subsidized the red states and that trend will continue under Obamacare.

But instead of funding health insurance in a way that maximizes coverage and allows us to reap the benefits of preventive care, state Republicans will keep the same broken system that makes American health care the most expensive and least efficient in the world.