While the Patient Protection and Affordable Care Act isgarnering plenty of criticism as it enters its third openenrollment period, there is at least one provision of the landmarkhealth law that many of the law's critics may soon be forced toembrace: the federally-funded expansion of Medicaid.

Montana became the 30th state to take part in the expansion onMonday, when the Obama administration approved the state's requestfor the additional federal funds, which will guarantee coverage forthose living up to 133 percent of the federal povertylevel.

Almost entirely financed by the federal government –– at leastin the near future –– the expansion has extended coverage tomillions of low-income Americans while avoiding many of theproblems that have bedeviled the private insuranceexchanges.

Even the governors who are holding out are getting pressure frommembers of their own party who have heard from cash-strappedhospitals and constituents struggling to pay medical bills.

Perhaps the most important example is Texas, the only state withan uninsured rate north of 20 percent. Although Gov. Greg Abbotthasn't budged an inch from his categorical opposition to anyObamacare-affiliated programs, a number of local leaders, includingconservatives, say that if the feds are going to be spending themoney, the least the state could do is try to get itsshare.

Judge Ed Emmett, the Republican chief executive of HarrisCounty, where Houston is located, has been begging for the moneysince the beginning. But his calls in 2013 to accept the money onbehalf of Texas taxpayers who were paying into the federal cofferslargely fell on deaf ears.

But now that local officials are seeing the economic effect ofthe expansion in other states historically burdened by highuninsured rates, such as Arkansas and Kentucky, the calls for Texasto drop its fight against the feds are growing louder. George Masi,the head of a Harris Health System, a community-owned health caresystem in Harris County, told NPR that he has recently had to layoff 100 workers, a decision that may have been averted with moreMedicaid funding.

"What is even more profound is that money is going to otherstates that expanded Medicaid, like New York, California,Connecticut," he said. "And so the taxpayer of Texas is beingpenalized, if you will, for not taking advantage of thatoption."

Ken Janda, who runs Community Health Choice, a nonprofitinsurer, floated an argument in favor of Medicaid expansion that someRepublicans will no doubt find hard to resist.

"If Texas expanded Medicaid, we would be able to look atreducing local property taxes across the board in all counties, oruse those dollars for something besides health care," hesaid.