Monterey, CA Supreme Court Strikes A Blow Against Medi-Cal Expansion In The Affordable Care Act Decision

In one of the most widely anticipated court rulings, The U.S. Supreme Court issued a mixed decision on President Barack Obama's health care reform today.  In a major blow to the White House, a majority of the Supreme Court (5:4) struck down the provision of the law that requires the states to dramatically expand the Medicaid (Medi-Cal) health insurance program for the poor.  Republicans were fighting ACA on a number of issues, and the Medi-Cal/Medicaid issue remained a hot potato because of the financial burden it would have put on the U.S. treasury. Currently, the federal government gives poor states 70% of their budget for Medicaid. States that are better off financially get 50% of the program funded. If ACA were implemented as written, 17 million of our nation's poorest would have been eligible to enroll in Medi-Cal and Medicaid, and the federal government would have bore the full cost of this for the first three years (2014-2016), a figure which would gradually decline to 90% by 2020. It would have been a great deal for the states, for sure. But with the federal government strapped for cash, many Republicans were wondering where the money to fund this ambitious health care program would come from. Some states were worried that even paying 10% for this huge influx of new beneficiaries would have been a big financial burden. 26 states had filed suit against the government, claiming that it's illegal to force these additional costs on them. The Supreme Court agreed.  However, the ruling was not all bad for the Obama Administration.  A sharply divided court today upheld the requirement that most Americans get insurance by 2014 or pay a financial penalty, which has been referred to as the individual mandate.  News service Reuters reported that Chief Justice John Roberts wrote for the court's majority in the opinion,"The Affordable Care Act's requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax."  He opined that, "Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness."  The court was divided on the opinion, with a vote of 5-4.