Comments on: The Likely Failure of Obamacare After ‘National Federation’ http://blog.oup.com/2012/07/failure-obamacare-national-federation-scotus/ Academic insights for the thinking world. Wed, 19 Jun 2013 15:22:49 +0000 hourly 1 http://wordpress.org/?v=3.4.2 By: OUPblog » Blog Archive » The “Choice” Bazaar http://blog.oup.com/2012/07/failure-obamacare-national-federation-scotus/#comment-304475 OUPblog » Blog Archive » The “Choice” Bazaar Fri, 26 Oct 2012 10:30:24 +0000 http://blog.oup.com/?p=26337#comment-304475 [...] was used by the right to object to the requirement that everyone take out health insurance as part of the new health care legislation. People should [...] [...] was used by the right to object to the requirement that everyone take out health insurance as part of the new health care legislation. People should [...]

]]> By: OUPblog » Blog Archive » Democratic Realism http://blog.oup.com/2012/07/failure-obamacare-national-federation-scotus/#comment-284882 OUPblog » Blog Archive » Democratic Realism Fri, 03 Aug 2012 12:30:42 +0000 http://blog.oup.com/?p=26337#comment-284882 [...] Stoker has argued, “almost destined to disappoint.” And yet instead of simply defining Obamacare as a good illustration of what is wrong with democracy in the United States it’s possible to [...] [...] Stoker has argued, “almost destined to disappoint.” And yet instead of simply defining Obamacare as a good illustration of what is wrong with democracy in the United States it’s possible to [...]

]]> By: Alex Klein http://blog.oup.com/2012/07/failure-obamacare-national-federation-scotus/#comment-282141 Alex Klein Thu, 12 Jul 2012 21:28:06 +0000 http://blog.oup.com/?p=26337#comment-282141 Professor Zelinsky exaggerates the ease with which states can reject the PPACA Medicaid expansion. Under the law, the federal government will at all times pay at least 90% of the new Medicaid costs. See 42 USC Sec. 1396d(y). Until 2017, it will pay 100% of those costs. So to reject the PPACA, state governors will have to explain to their uninsured citizens why they refused free (or 90% free) coverage. The risks are financial: citizens will move out of states that don't offer expanded coverage, causing their tax bases to shrink. And the risks are political: the uninsured who remain are (more) likely to campaign against non-cooperating governors. This isn't to say some states won't opt out. Some might, and some have already said they will. But easier said than done. This isn't a state decision on whether to pay for uninsured people out of pocket; it's about whether to accept giant sums of cash to simply hand over to those citizens. Professor Zelinsky exaggerates the ease with which states can reject the PPACA Medicaid expansion.

Under the law, the federal government will at all times pay at least 90% of the new Medicaid costs. See 42 USC Sec. 1396d(y). Until 2017, it will pay 100% of those costs. So to reject the PPACA, state governors will have to explain to their uninsured citizens why they refused free (or 90% free) coverage. The risks are financial: citizens will move out of states that don’t offer expanded coverage, causing their tax bases to shrink. And the risks are political: the uninsured who remain are (more) likely to campaign against non-cooperating governors.

This isn’t to say some states won’t opt out. Some might, and some have already said they will. But easier said than done. This isn’t a state decision on whether to pay for uninsured people out of pocket; it’s about whether to accept giant sums of cash to simply hand over to those citizens.

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