Medicaid after the Supreme Court decision

In late June, 2012, the Supreme Court of the United States issued its rulings on a set of challenges to the Affordable Care Act (ACA) (so-called Obamacare). While leaving controversial parts of the Act such as the individual mandate to have health insurance intact, the Court ruled that an expansion of the Medicaid program to cover a previously uncovered group of Americans was not permissible. This ruling has shaken the health policy community in the United States and creates an uncertain future for both Medicaid and the ACA. Most policy analysts project that the ACA will lead to 32 million currently uninsured Americans receiving health insurance, almost half of those through an expansion of the Medicaid program to childless adults who would be covered up to 133% of the federal poverty level. For whatever reason, the Supreme Court has heightened the tensions between a federally controlled Medicaid program and one in which the federal government merely finances what the states wish to do (Rosenbaum and Westmoreland, 2012).