Massachusetts has won another round in its effort to get U.S. taxpayers to help fund its experiment in universal coverage.

Gov. Deval Patrick announced Tuesday that the federal government has approved an extension of its waiver, allowing the state to continue to provide Medicaid subsidies to people making as much as $63,600 a year. Federal taxpayers will be paying nearly $11 billion to help the Bay State fund its $21-billion health reform plan over the next three years.

Gov. Patrick has been boasting that 439,000 more people in the Bay State have health insurance since the reform law was passed in 2006. But at least 56% of them are getting free or heavily-subsidized coverage, jointly funded by the state and by federal matching Medicaid dollars.

The jury is still out on how the state will juggle growing opposition to the individual mandate and soaring health costs, but U.S. taxpayers apparently will continue to fund the plan to see if it works. While the federal government would have been funding part of Massachusetts’s Medicaid program in any case, the big open question is how the government can now deny similar requests from other states that want to follow suit and also increase Medicaid eligibility to 300% of poverty -- $63,600.

Before that happens, it might be wise to have a national debate on whether or not Medicaid should be the vehicle to expand taxpayer-funded health coverage to millions more middle-class Americans.