[The Supreme Court ruling that made the Medicaid expansion a state option] lead to constant speculation regarding which states would exercise the ability to opt-in or opt-out of Medicaid. Fed by the high profile case, national media have been tracking the expansion through color-coded maps that tend to rely on a five category sorting. States that have been categorized as not participating, leaning toward not participating, or alternative have been in constant flux over the last several months. The majority of these states have performed or are engaging in studies, negotiations, and other processes that move them toward participating in the Medicaid expansion. Though the media have reported that only half of states are participating, of the remaining states categorized as not participating or leaning toward not participating, all but about six are actively debating and planning to expand. The future of Medicaid expansion is not nearly as bleak as the media suggests. If anything, the Medicaid expansion is beginning to expose an animated set of political choices at both the state and the federal level that feed a dynamic federalism story that has so far evaded the Court’s understanding. The story of the Medicaid expansion is just beginning, and it will take time to fully develop the research I have begun to analyze here, but the preliminary enquiry indicates strong prospects for Medicaid expansion.