The Problem With the Private Option

Wednesday, 06 August 2014 10:24
By A.W. Gaffney, Truthout | News Analysis

Last week's dueling federal appeals court decisions on the legality of subsidies under the Affordable Care Act (ACA) cast - yet again - uncertainty on the future of President Obama's health care law. Yet even as this latest case plays out, the consequences of previous legal challenges to the law are still unfolding - to some extent in surprising ways.

When, for instance, the Supreme Court made the ACA's expansion of Medicaid optional for states, it was clear that this would limit the law's reach for some time to come: Even today, some 24 states have failed to expand the program, a number that includes many of the states that need it the most. But as I'll explore here, the Supreme Court's decision also had a less predictable effect: It gave conservatives power to remake the Medicaid program. As Sarah Kliff of The Washington Post put it, while Obamacare is expanding Medicaid, it is ironically making it "more Republican" too.