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WASHINGTON — While the Supreme Court on Thursday morning left the Patient Protection and Affordable Care Act mostly intact, the court did rule that Congress cannot withhold federal Medicaid spending from a state that does not expand its eligibility requirements under the act.
Under the Affordable Care Act, Medicaid was to be transformed into a program to meet the healthcare needs of the entire nonelderly population with income below 133% of the poverty level.
According to the decision: "The threatened loss of over 10% of a state’s overall budget is economic dragooning that leaves the states with no real option but to acquiesce in the Medicaid expansion. … The Medicaid expansion thus violates the Constitution by threatening states with the loss of their existing Medicaid funding if they decline to comply with the expansion."