Two years ago, the Obama administration called the near-total, initial meltdown of the ObamaCare federal exchange a technical “glitch.” The term was widely ridiculed at the time, especially since it took weeks to fix the exchange’s website, healthcare.gov.

At Saturday night’s Democratic debate, front-runner Hillary Clinton called soaring health care costs and deductibles “glitches” resulting from the Affordable Care Act.

On December 14, former Secretary of the Department of Health and Human Services Kathleen Sebelius made news by calling the decisions of Kansas and Missouri to turn down the Medicaid expansion contained in the Affordable Care Act “morally repugnant and economically stupid.”

Heated political rhetoric does not alter the fact that a state’s decision to expand Medicaid involves complicated tradeoffs.