- Joined
- May 22, 2012
- Messages
- 104,359
- Reaction score
- 67,503
- Location
- Uhland, Texas
- Gender
- Male
- Political Leaning
- Libertarian
I think it's the right thing to do.
Look, the PPACA provides block grants to the states to set up their HIEs. As such, no state really has to spend a dime. Moreover, the Treasury would provide additional non-matching funds for Medicaid for the first 2-yrs once the PPACA goes into effect in 2014. Yet, Republican governors are refusing to establish the state-sponsored HIEs even after most of them stated publically they'd hold off starting them until after the election - a clear indication that if Romney won they'd do nothing except wait for the law to be repealed. But that wait-and-see approach backfired and now these Republican governors have to wait on their congressional Republican colleagues to either defund the PPACA or hope one of their law suits finally wins over the Supreme Court.
It's more obstructionism, plain and simple. Regardless, the law clearly states that if the states choose not to set-up an exchange, the fed would do it for them and charge them accordingly. At this point, those states that continue to refuse to adhere to the law have only themselves to blame and their residents can bitch to their Governor.
What? Would you care to show us that portion of the PPACA law? This was the portion of PPACA that the SCOTUS struck down as unconstitutional by a 5-4 decision - it called for withholding the federal Medicaid for states that "opted out" of setting up their own exchanges.
Medicaid Expansion, Regulations & Spending Clause
As a part of the Medicaid Expansion of PPACA, States are compelled to follow new regulations or risk losing their current Medicaid funding. This part of the bill was also under the constitutional microscope. The result was a 5-4 overturning of this part of the bill. Here is the crux of the issue:
Congress may use its spending power to create incentives for States to act in accordance with federal policies. But when “pressure turns into compulsion,” ibid., the legislation runs contrary to our system of federalism.
More specifically, the decision came down to the accountability of our democratic system:
…when the State has no choice, the Federal Government can achieve its objectives without accountability…
“[W]here the Federal Government directs the States to regulate, it may be state officials who will bear the brunt of public disapproval, while the federal officials who devised the regulatory program may remain insulated from the electoral ramifications of their decision.” Id., at 169.
Had non-compliance only risked loss of the medicaid expansion funding, it may have survived constitutionality in this regard:
…Spending Clause programs do not pose this danger when a State has a legitimate choice whether to accept the federal conditions in exchange for federal funds.
Implications:
For practical purposes, the threat of losing current medicaid funding will not be permitted to induce compliance to the new regulations. The decision, also, sets a strict precedent limiting the power of the federal to govern the states.
The above quote was taken from : PPACA Supreme Court Decision: Just the facts | Business Insurance