A Few Additional Thoughts

Adding to my earlier blog post, which I'm certain you've all ready by now, there may be an interesting twist to the tax v. mandate decision in combination with the inability to force states to expand medicaid rolls. This would allow states to refuse compliance without penalty, cost shifting the additional millions onto the feds and making the plan unworkable unless the feds vote on a direct tax to cover the expenses they were passing on to the states. No one is going to intentionally bankrupt their state (minus California) on the program when they can cost shift to the feds without penalty. No fed is going to vote for the even more massive tax hike that would be needed to fund it. Roberts may have effectively gutted the funding for the program by holding the mandate as a tax.