Nathan DealThe furious response of Republican governors nationwide to the U.S. Supreme Court’s health care ruling last week has left Georgia’s chief executive one of the odd men out as state governments from Florida to Wisconsin forswear a federally prescribed expansion of Medicaid rolls.

The high court’s decision that federal lawmakers lacked the authority to legislative punitive remedies to those states that reject the expansion effort–lower enrollment hurdles in the Affordable Care Act would extend the franchise to some 32 million Americans according to estimates–has set off a chain reaction of GOP governors abandoning the overhaul.

But even as Georgia Governor Nathan Deal has expressed reservations over the costs associated with the unprecedented expansion, he remains one of the increasingly few who have not withdrawn their state from participation.

The controversial federal health care law stipulated an expansion of Medicaid eligibility guidelines jointly underwritten by state and federal tax dollars. The federal government would own 100 percent of the costs for the first three years, but state coffers would begin contributing 10 percent to the effort thereafter. (The law originally included a provision that punished those states that failed to comply, stripping them of already-appropriated Medicaid funds.)

That huge new outlay, most GOP governors say, is simply too great a burden on state budgets. Participation no longer mandated, simply put: few are.

Republicans Nikki Haley of South Carolina, Bobby Jindal of Louisiana, Scott Walker of Wisconsin, Rick Scott of Florida, Dave Heineman of Nebraska have all opted out. Other GOP guvs–like those in Mississippi, Maine and New Jersey–have at least said they are reluctant to participate.

Federal legislators and regulators failed to anticipate the direction of Supreme Court’s health care opinion last week, so states face no deadline to decide. Medicaid directors are not even certain if states can drop out after first enlisting.

The state’s Democratic Congressional delegation is leaning hard on Deal to adopt the new guidelines. Reps. John Lewis, David Scott, Sanford Bishop and Hank Johnson told the governor in a Friday letter that the expansion was “the right thing to do” for the state.

But all indications are that Georgia–one of 26 states whose challenge the court heard–will delay the tough call until at least the fall.

– James Richardson