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If states decline to expand Medicaid, the White House will have to rely exclusively on the more costly, federally subsidized exchanges as a way to offer coverage. Providing states the administrative flexibility to manage their Medicaid populations — including how and when to expand coverage — could help governors provide better quality health coverage to their low-income populations.

Enhanced state flexibility is one way to ameliorate some of the errors of Obamacare. On Dec. 4, 11 Republican governors wrote to President Obama requesting a meeting to discuss Medicaid. The governors proposed five “tenets of Medicaid reform,” including flexibility ideas and proposals to streamline funding and improve health outcomes. That letter, along with a follow-up request sent just last week, remains unanswered.

The White House has an opportunity to finally say “yes” to the legitimate and continuous requests from governors to run their Medicaid programs in a way that makes most sense. Moreover, governors have a chance to say “no” to a big part of Obamacare if Washington insists on attaching unreasonable and unworkable conditions. This is a moment of opportunity and leverage states should not waste.

Rep. Fred Upton, Michigan Republican, is chairman of the U.S. House Committee on Energy and Commerce.