While not the optimal means of Medicaid expansion, the compromise accepted by Arkansas was a major advance for health care access. This means that Republicans in the state are refusing to go ahead with it. Which makes sense, since they’re opposed in principle to providing decent health care to the working poor.
And related to yesterday’s post, once again let’s thank John Roberts for yet another arbitrary, extratextual limitation on federal power. The arguments for the spending power limitations in Sebelius are perhaps not as terrible as Shelby County — what is? — but it’s close. Put it this way — if Congress had created the ACA’s Medicaid program from scratch, it would be plainly constitutional. If it had simply eliminated the old Medicaid entirely, that would be plainly constitutional. So how can making states an all-or-nothing offer including the Medicaid expansion be unconstitutional? It can’t — the argument collapses on itself.