When Stephen Espalin, a homeless 57-year-old man living in Florida experienced severe chest pains but did not have the resources to get medical help, he told Boca Raton police and U.S. Secret service agents that he had sent a bomb to the president at the White House in the hopes of killing Obama, his family and even the family dog, Bo. Once arrested for the threat, it quickly became clear that Espalin, who already has a lengthy criminal record, had no means or any real intent to hurt anyone. He pled guilty and received a sentence of four years and three months, all so he could get access to free medical care through the prison system. Espalin is hardly the only one to have resorted to such tactics in Florida and elsewhere. But such actions draw a spotlight on the challenges surrounding state expansion of Medicaid, which would cover destitute people like Espalin who seem intent on getting coverage for their ailments one way or the other.