Needless to say, just about everyone is stunned at the 5-4 decision upholding Obamacare’s mandate as a tax – despite the clear writing in the legislation that it was not a tax. The sleeper issue all along has been the Medicaid provision and digesting exactly what the Court decided on that will take some time, but it appears states will be in a position to opt out of the expansion without being penalized. That was one of the most fascinating arguments in March’s hearings. Here is the decision
“As for the Medicaid expansion, that portion of the Affordable Care Act violates the Constitution by threatening existing Medicaid funding. Congress has no authority to order the States to regulate according to its instructions.Congress may offer the States grants and require the States to comply with accompanying conditions, but the States must have a genuine choice whether to accept the offer. The States are given no such choice in this case: They must either accept a basic change in the nature of Medicaid, or risk losing all Medicaid funding. The remedy for that constitutional violation is to preclude the Federal Government from imposing such a sanction. That remedydoes not require striking down other portions of the Affordable Care Act.”
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