Matters of Life and Death
By 
15,000 people died in three years because Republican states refused to accept the Medicaid expansion:
About 15k people died between 2014-2017 as the result of states deciding to not expand Medicaid eligibility through the ACA. pic.twitter.com/KVdD83ekac— Sarah Miller (@smilleralert) July 22, 2019
And these unnecessary deaths, along with a lot of other unnecessary suffering and financial distress, are still happening in many cases.
And let us not forget that this was all made possible by the intervention of the Supreme Court, based on arguments so weak that, as Joan Biskupic’s new bio finds, John Roberts himself initially rejected them:
Your reminder that the argument that the most recent Medicaid expansion was the first ever unconstitutional use of the federal spending power was so weak and incoherent Roberts himself initially rejected it pic.twitter.com/KxrkS1H6pi— Scott Lemieux (@LemieuxLGM) July 22, 2019
That Kagan and Breyer’s votes were strategic was the most obvious thing in the world, although it’s useful to have confirmation. (Biskupic, not surprisingly, also found that Kagan and Breyer switched their votes to meet Roberts halfway in part because they believed states would generally accept the expansion anyway.) But even if Roberts’s initial Medicaid vote was “tentative,” this is incredibly damning. The Medicaid holding his no direct basis in the text of the Constitution, and the doctrine strongly indicated that the expansion was constitutional. It is one thing to cast a vote with horrible consequences if black letter law clearly requires it. This was not such a case, not even close. Not only did the existing law clearly permit the expansion to be upheld the case for upholding it was much stronger than the case against. Roberts voted to re-write the expansion not because he thought the law compelled him to but because having switched his initial vote to strike down everything but the Medicaid expansion he wanted to inflict some kind of damage on the ACA, and the expansion is the policy that Republicans find least congenial. That’s it. But literal life and death issues are not the place to try politically motivated, half-assed doctrinal revisions Congress had absolutely no reason to think was coming. This switch in time that is killing thousands of people a year is a disgrace on Roberts’s record.