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It represents pre-New Deal rulings "in which the Court routinely thwarted Congress' efforts to regulate the national economy in the interest of those who labor to sustain it."
In other words, the Court restricted congressional authority to pass social welfare laws. Doing so makes planned cuts easier.
The ruling also limited Medicaid's expansion. Seven justices said Congress exceeded its constitutional authority to coerce states to participate by threatening to cut off federal funds. They can opt out of Medicaid's expansion if they wish.
Doing so undermines efforts to cover individuals under age 65 with incomes of 133% above poverty or less. Around 11 million Medicaid recipients are affected. They already receive minimal care.
Experts say America's poorest are left in "no-man's land." They'll be uncovered by federal benefits and ineligible for subsidized insurance.
PPACA provides 100% of funds to expand Medicaid until 2016. Thereafter, it's 90%. Until now, federal funding required state participation. No longer. Millions will be harmed. Many will be left out entirely.
Medicaid expansion provided coverage for around 17 million Americans by 2019. States now can opt out at their discretion.
Matt Solo, executive director of the National Association of Medicaid Directors said states have a major decision to make.
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