Pennsylvania became the 27th state to expand Medicaid on Thursday. Though the agreement between the Obama Administration and Republican Governor Tom Corbett is far from perfect, it does mark a milestone worth pointing out.

Call it the “270 Mark” or the “276 Mark,” to be exact.

A Republican candidate for president can not take the White House without winning a state that has expanded Medicaid. Even if nominee Cruz, Bundy or Trump won all the red states that have expanded — Arkansas, Arizona, Kentucky and North Dakota — thus far and the hold-out states, that would only give him 262 electoral votes, eight shy of what it takes to win.

Will this stop Republicans from running on repeal? Oh, hell no. Or, oh, hell probably, sort of no.

Republican nominees for Senate Scott Brown, Tom Cotton and Terri Lynn Land are all running on a promise to repeal the Affordable Care Act while promising, vaguely, to keep their states Medicaid expansion by implementing Romneycare or something.

Still, it will be easy for Democrats to make to the case to millions of new Medicaid beneficiaries that Republicans want to take away their health insurance — since full repeal with no plan to replace is the dominant stand of the party.

A Republican nominee may end up in a bind where he will actually have to explain what happens to the people whose insurance they want to cancel, which will dishearten at least some of the GOP base who will always cling to #FullRepeal.

Medicaid expansion has been the unqualified success of the Affordable Care Act, covering at least 6.9 million Americans who earn too much to qualify for regular Medicaid. The initiative directly aims to reduce income inequality by funding coverage for poor working families funded by taxing corporations and the rich, which is why Republicans hate it. And a recent study shows it immediately reduces hospitalizations, depression and financial hardships.

Expansion also offers an impressive success story for conservative reformers, who will likely ignore it rather than pointing out a remarkable achievement from a law they’ve demonized for half a decade now.

Arkansas, which has had the largest reduction of its uninsured population of any state in the union, has now confirmed that rates in the state will on average go down by 2 percent. Insurance premiums, as far as I know, haven’t gone down anywhere in this nation for decades, possibly longer. On average, they’ve been going up around 10 percent.

This is like finding a Republican willing to raise taxes on the rich. It’s just not supposed to exist in America.

Arkansas did this in a unique way by putting the healthy residents eligible for expansion in the state’s exchange to pick private coverage. The sickest residents fed into the public Medicaid program. We don’t know yet if the savings in subsidies from rates going down will make up for covering those who need the most medical attention. But we do know that 45 percent of the state’s uninsured population can now see a doctor and the state’s residents will be paying less as a result.

It’s been easy to run against a law that had only subtly improved Americans health care while absorbing every possible complaint about our still imperfect system.

Soon, Republicans have to run on tearing down a system that’s clearly starting to work.

[Map via 270toWin.com]