Governors are  meeting in Washington, DC, this week for the annual National Governors  Association conference, and one of the major topics of discussion is  their strong objection to the mandatory expansion of Medicaid spending.   Not only are they worried it could wreak havoc with state budgets, but  we write in our book about the particular impact that this will have on  the most vulnerable Americans, particularly disadvantaging those on  Medicaid who have few if any other options for access to health care.