While the U.S. Supreme Courtupheld the individual mandate in the Affordable Care Act, it also knocked down a hugely significant provision of the law. Democrats may have been so giddy over what happened Thursday — "John Roberts gave us a break?!" — that the impact of this hasn't quite sunk in.
The high court said the federal government cannot compel the states to cooperate in a broad expansion of Medicaid. That was anticipated to provide health care for 16 million to 17 million people, half the people who would gain care coverage under the law.
In essence, anyone who earns up to 133 percent of the federal poverty rate would be covered. The law sought to force the states to add those people to their Medicaid rolls. If a state refused to comply, it could lose all of its federal Medicaid funds.
That, wrote Chief Justice John Roberts, "is economic dragooning that leaves the states with no real option but to acquiesce in the Medicaid expansion."
This is big: Twenty-six states challenged the constitutionality of the Affordable Care Act on the grounds that the individual mandate and the Medicaid requirements were unconstitutional. National health care may turn out to be not so national after all, if most or all of those states walk away. With so many states struggling to pay the cost of Medicaid now, that's a distinct possibility.
No comments:
Post a Comment