The refusal of Republican states to accept Obamacare's Medicaid expansion surely ranks as one of the most sordid acts in recent American history. The cost to the states is tiny, and the help it would bring to the poor is immense. It's paid for by taxes that residents of these states are going to pay regardless of whether they receive any of the benefits. And yet, merely because it has Obama's name attached to it, they've decided that immiserating millions of poor people is worth it. It's hard to imagine a decision more depraved.
Conservatives hate it when you accuse them of simply not caring about the poor. Sometimes they have a point. This is not one of those times.