This seems to be the big caveat in the ACA SCOTUS ruling that few people have seemed to be discussing. Yes, the ACA has passed constitutional muster for the most part, as the intended Medicaid expansion mandated in the law - a provision that will ostensibly generate more insured people than the infinitely more contentious individual mandate - has now been deemed to be unconstitutionally coercive. Though the measure was not invalidated, the states now have the option to either (a) expand their Medicaid program as per the ACA and subsequently adhere to all of the federal stipulations that that action will imply, or (b) leave their Medicaid programs as they were before the ACA was passed. That’s my understanding of the ruling anyway.
What will be the practical effects of this SCOTUS caveat in terms of the successful implementation of the ACA? I said in an earlier thread that I think it’s unlikely that ANY state (save for super Reds like Mississippi or something) will ultimately say “no” to all of the federal funding that would go along with their expansions of their respective Medicaid programs, but that possibility still leaves the door open for a stark alternative. Basically, there might be MASSIVE gaps in coverage between the liberal states that accept the expansion (California, Vermont, Massachusetts, etc.) against the conservative states that hold out.
What do you guys think will be the practical outcome in this case?