The Governor’s Gamble

Just starting to read the coverage of the Supreme Court ruling (until I can read the opinion itself, which doesn’t seem to be up yet), and it looks like the governor’s gamble that the Court would strike down the provisions of the Affordable Care Act didn’t pay off.

In the last months of the 2012 legislative session, the governor made several decisions which were based on the assumption that there would be no Affordable Care Act by the fall of 2012. The governor halted the state’s movement towards creating a state health insurance exchange, required by the ACA, and the governor’s budget also ended coverage for young people on MaineCare, which is prohibited under the Maintenance of Effort provision of the ACA. Because Maine did not set up a health insurance exchange on its own, the federal government will now design one for us – unless we get our act together and create a proposal for a joint state-federal exchange design by November.

Can’t wait to read this opinion!

ETA: Decision now available! I have to say I am seriously, seriously confused by the Court’s decision to declare the withholding of Medicaid reimbursements unconstitutional. This is how the federal government works through “cooperative” (or “coercive”) federalism. States can choose whether they want to participate in federally-supported Medicaid or not, and the federal government sets the terms for what they need to do to participate. This is exactly the mechanism used by President Reagan to create a national drinking age of 21: he threatened to withhold federal highway funding unless states all raised the drinking age. More to come, for sure.

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