Tennessee's Republican governor, Bill Haslam, has found a way to expand the coverage of the state's Medicaid program for the poor without forcing the state's taxpayers to pay, NPR reports. Instead, he's gotten the state's hospital association to pay the bill. They'll come out ahead anyway because the program will bring in more federal dollars.
One political advantage of this solution from the Republican point of view is that it prevents Democrats from making it look as if Governor Haslam is preventing poor people from getting health care. Also, it prevents Tennesseans from being forced to pay (at least through their state taxes) for an ObamaCare provision that winds up redistributing money from people with private insurance (or non-Medicaid government insurance, such as Medicare) to those without it (and to their health-care providers).
Another angle (unexplored in the NPR article) is that, even though hospitals often claim they lose money on Medicaid patients because the reimbursement rates are so low, the Tennessee hospital association was still willing, albeit under pressure, to accept this deal.