Former Health and Human Services Secretary Kathleen Sebelius isn’t mincing words when it comes to the political leaders who have refused to accept federal dollars to expand Medicaid in their states.

“It is morally repugnant and economically stupid policy for both Missouri and Kansas,” she told the Kansas City Star, referring to both states’ continued opposition to participating in one of the key parts of the Patient Protection and Affordable Care Act.

Kansas, where Sebelius was governor for six years before joining the Obama administration in 2009, fits the political profile of most other states that rejected the expansion. It has a conservative Republican governor and a GOP-controlled legislature.

Missouri, however, has a Democratic governor, Jay Nixon, who has begged the legislature to accept the money. But the Republican-controlled legislature wanted nothing to do with it.

But cracks in the Republican opposition to Medicaid expansion, visible since the beginning of the Obamacare fight, have split wide open over the past year. Republicans in many states, sensitive to attacks from Democrats for denying their constituents their share of federal dollars, are now seeking exit strategies from the ideological box they put themselves in two years ago.

The threat of the Medicaid issue to Republicans appeared to be on display in Louisiana, where a Democratic candidate, John Bel Edwards, recently won an upset in the governor’s race after railing against GOP opponent Sen. David Vitter for opposing expansion. And he did so by hardly mentioning “Obamacare.”

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Sebelius calls states &quot;repugnant&quot; for not expanding Medicaid

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Sebelius calls states "repugnant" for not expanding Medicaid