One of the most troubling aspects of the new Virginia transportation law signed by Gov. Bob McDonnell is the provision that will allow a bicameral commission to decide whether the state will end up expanding Medicaid. McDonnell added the measure to glean some Democratic support for his bill, confident in the legislature’s Republican majority to keep the state safe from ObamaCare’s Medicaid-expansion clutches, but here’s my question: Why would the Democrats ever have agreed to that as a concession if they didn’t think they had a snowball’s chance in hell of making it work? As the WSJ put it, just “wait until the hospital lobby gets done working the same Republicans who raised taxes.”

Because there’s certainly been plenty of that going on throughout the rest of the country. Lobbyists have been more than just a bit player in influencing red states that haven’t held the line on creating health insurance exchanges and/or expanding Medicaid, as Tim Carney reports today, and it looks like thoroughly-red Idaho may be the next to cave because of it:

“They lobbied greatly,” Idaho state Sen. Monty Pearce, a Republican exchange opponent, told me about the health care sector and the legislation to create the insurance exchange. “They’ve been lobbying on it for a couple of years. … They’ve hired every lobbyist they can get.”

The Idaho Hospital Association has made a state exchange a priority while also lobbying to expand Medicaid. Another leading exchange backer is the Idaho Association of Commerce & Industry — one of the biggest-spending lobbying organizations in Boise. Dozens of Idaho businesses, led by insurers and health-care providers, formed the Idaho Health Exchange Alliance to back Otter’s push for an exchange.

These pro-exchange health-industry companies also poured money into legislative campaigns. Comb through the campaign finance disclosures of most Idaho state senators and you’ll see gifts from drugmakers (GlaxoSmithKline and Pfizer), insurers (Blue Cross of Idaho and PacificSource Health Plans) and industry groups (Idaho Hospital Association, the Pharmaceutical Research and Manufacturers of America, and the Idaho Health Care Association). …

In Ohio, Republican Gov. John Kasich recently announced he would expand Medicaid as prescribed — but not required — by Obamacare. “We have been actively involved” in pushing this expansion, Cleveland Clinic top lobbyist Oliver Henkel told my Washington Examiner colleague Philip Klein. The clinic reached out early on to Kasich’s administration and helped win them over.

Oof. It’s not like we would’ve expected anything else, judging from what went down on the national level with ObamaCare; President Obama once lamented that “each time lobbyists game the system or politicians tear each other down instead of lifting this country up, we lose faith,” but his signature law certainly engendered enough of it.