States can opt out of Medicaid expansion, citizens must buy x, and that's a progressive victory?

[SickOfTheOnePct]

51. I'm not saying it's a loss for everyone

But it's certainly a loss for poor people that, prior to this ruling, would have been covered under Medicaid and now won't be.

Of course it's an overall win, but it's certainly a loss for people that still won't have coverage due to the ruling today.

There is also the potential that a state could, if they choose, contract their current Medicaid coverage in order to save even more money.

For example, (and for ProSense, these numbers are just examples, not real numbers), if a state is currently required to offer Medicaid to anyone that is at 100% of the poverty level, with a 57/43 federal/state split, then that state could, in theory, decide to only cover people at 75% of the poverty level. Doing so would obviously reduce their Medicaid rolls, thus saving the state $43,000 for every $100, 000 they were paying out in fees/costs.

Until today, doing so would risk the federal government cutting off all Medicaid funding. But today's ruling is clear that the threat of taking away all funding is no longer an option. So, what is to stop cash-strapped states from reducing the number of Medicaid recipients in order to save money?

Yes, today is an overall win, but there are many people that won't have the coverage that they would have had prior to the ruling.