under the bus?

or over the edge, as the expression goes?  from truthout, more analysis on the u.s.s.c. ruling,  with respect to the so-called medicaid expansion.

While upholding the most hotly debated part of the health care overhaul law — a requirement that most Americans have health insurance or pay a penalty — the Supreme Court said in its ruling on Thursday that states did not have to expand Medicaid as Congress had intended — leaving a huge question mark over the law’s mechanism for providing coverage to 17 million of the poorest people.

In writing the law, Congress assumed that the poorest uninsured people would gain coverage through Medicaid, while many people with higher incomes would receive federal subsidies to buy private insurance. Now, poor people who live in a state that refuses to expand its Medicaid program will find themselves in a predicament, unable to obtain either Medicaid or subsidies.

the article reports that medicaid has repeatedly expanded over the last 25 years, but this time may be different, and it's not just about red and blue.  illinois, for example, a blue state in deep financial trouble, is delaying Medicaid payments to health care providers - and Dennis G. Smith, secretary of the Wisconsin Department of Health Services, states, “Virtually all states are struggling to sustain their current Medicaid programs.”

meanwhile, other citizens joyously celebrated the court's decision - below, an enthusiastic Missouri rally attended by seniors, women, students, and health care activists.



single payer supporters appear divided on whether the court's decision represents a step forward or backwards on behalf of Medicare for All.  (continue backwards in blog time from that link to more information on the topic.)