When Republican presidential candidate Donald Trump formally announced Indiana Gov. Mike Pence as his running mate last Friday, commentators pointed to the ideological conservative's strong positions on right-leaning social issues as a sign of deference to party officials, and influential members of the GOP Congressional leadership were quick to offer their congratulations.

One year ago, however, extended negotiations with the federal government over Indiana's eventual expansion of Medicaid under the Affordable Care Act led to sharp condemnation from Republican lawmakers.

Although Pence continually denounced Obamacare and insisted Indiana would not establish its own exchange, he did eventually enroll eligible state residents within the federal protection, but only after arranging concessions that more closely corresponded with conservative economic policy. Liberal advocates criticized several of the stipulations as unnecessarily rigorous or counterproductive.