Elizabeth Jo

But if they didn't decide to expand it, they would lose all of their current funding as well.

And the court said, that's not a true choice.

You're really forcing them to do things that they don't want to do.

Yeah.

And then that's why the ACA has been alive ever since.

The one portion of it was struck down, but the vast majority of the ACA stood up.

The Supreme Court chooses this pretty violent metaphor of saying, you know, giving or offering money on the condition of is kind of like putting the gun to the head of the states, which is, number one, weird because, you know, it's treating states as if they're people and that they have some independent authority or like control.

It's actually wrong.

Our representatives, we've made choices.

A lot of states didn't mind the Medicaid expansion, you know, but that's in a way what you point out to is funny because the Supreme Court has said that the anti-commandeering principle, right, which is that the federal government can't treat the states in particular ways.

That applies even if the states say, let's say the states want to participate in a regulatory program and they say, sure, regulate us this way.

And the federal government does it.

The Supreme Court has made it very clear the states can't even consent to it.

The states can't even get together and say, oh, please commandeer us.

The court says federalism is so important.

It doesn't matter if nobody wants it.

Yeah.

That we are here to uphold it.

So it's not that some goals are good and some are bad.

It's simply telling Congress you cannot do it in this way.