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Obamacare supporters and protesters gather in front of the U.S. Supreme Court to find out the ruling on the Affordable Health Act June 28, 2012 in front of the U.S. Supreme Court. California is already ahead of the curve on expanding Medicare. Will the nation follow?
One of the critical elements of the just-released Supreme Court decision on the Affordable Care Act, or "Obamacare," is the piece that gives states the option of saying no to money from the government that would have expanded Medicare coverage. This is from Josh Barro at Bloomberg:
Today’s Supreme Court ruling upheld the individual mandate in the Affordable Care Act. But it did strike down one part of the law—the provision that withdraws all Medicaid funding from states that do not expand eligibility to all people under age 65 living below 133 percent of the poverty line. States that do not expand eligibility will have to forgo only those federal funds that would have financed the expanded coverage, not all Medicaid funds.
I'm no legal scholar, but the debate over this piece of the law is a fairly straight-up case of federalism versus states' rights, that oldest of American Con Law dustups. Here's how it goes: The law as written would have effectively taken away all Medicaid money that didn't participate in the ACA expansion. That would represent a federal penalty imposed on the states for saying "No thanks" to the extra money.