In some of our redder states, political leaders are pushing back against the Affordable Care Act, declining Medicaid expansions and refusing to set up health exchanges. In some of these states, supporters may turn to ballot initiatives to try push past conservative opposition. Politico reports:

Putting anything as volatile as President Barack Obama’s health law on the 2014 ballot is risky — more so if the rollout of the law is rocky next year, less so if people start seeing tangible benefits. The health law, after all, was a big reason the Republicans captured the House and made gains in the Senate in the last midterms, in 2010. And ballot initiatives could stoke emotions and affect turnout in unpredictable ways in the 2014 midterms, when the health law is still likely to be a raw political issue.

“If Obamacare is on the ballot, people will line up to vote against it again,” said Bowen Greenwood, executive director of the Montana Republican Party. “Historically, it’s always a major turnout driver for us.”

Nevertheless, local groups in Montana and Ohio that back the law say they’ve begun mobilizing for 2014. Florida stakeholders say a ballot initiative is “on the table” if a bitter standoff continues there. And there’s some early-ballot talk among stakeholders and lawmakers in Arizona, too.

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