Most people on expanded Medicaid do NOT want to be hard working tax paying Americans.  (Expanded Medicaid covers able bodied adults with no dependents - NO reason for these people to get a free ride!!!!) I have worked in social services for decades. Almost everyone I know who works in social services providing direct services to "needy" people is sickened by the fraud and laziness we see on a daily basis.  People don't want to work. Many are drug addicts or lazy or entitled or both.  You have no idea!  Programs like "expanded Medicaid" are ruining our country.  People have no incentive to help themselves.  It is a tragedy on many levels.