Here's a hard truth about the Supreme Court's decision on the Affordable Care Act: The people who are going to suffer most from it are the people who need the help most. ...David Graham at The Atlantic
You can practically smell Scalia's sweat, can't you, seeping into the final opinion. The basis for that decision made some sense -- "The federal government can't force the states to take money and spend it on the expansion" -- particularly if you want to undermine the Commerce Clause (that's my take, anyway).
The Advisory Board Company has issued a map showing "where each state stands on Medicaid." If you look at that map, you'll see that some of the states rejecting Medicaid expansion are the very states that need it most -- or rather, the very states with the most people without medical care and the most people who will suffer from the politics of Rick Perry and the abject stupidity of those with political power in Maine. Or with Chris Christie at helm.
If President Obama is reelected, or if the GOP fails to effectively repeal Obamacare, it will be interesting to see the longer-term results of these choices. Many analysts seem convinced that every state will eventually give in and accept the expansion, finding they can't just leave all that money on the table. But what if they don't? Will there be a gradual but inexorable migration of lower-income citizens to states that expand Medicaid? Will states that refuse the expansion develop a sort of permanent medical underclass? Or will those governments eventually devise some sort of alternative system? ...David Graham, Atlantic