MacGillis also points to the re-election last year of Maine’s governor, Paul LePage, who has long pushed for more restrictions on welfare programs in a state where nearly 15 percent of residents are on food stamps—third highest in the country.
Of that increase, more than 16 percent was for Medicaid expansion, which has caused total federal Medicaid spending to grow from $85 billion to $350 billion in just two years.
Federalism has long been a contemptible and ridiculous thing to Washington DC, but at least it was couched in the pretense of cooperation.
The complaint, which Kansas and Louisiana also joined, reveals how progressive regulatory schemes such as the Affordable Care Act (ACA), in order to accomplish their goals, eventually wind up coercing state governments and in some cases imbuing private entities with legislative powers.
The main thing all these plans have in common is that they would repeal Obamacare's coverage expansion and replace it with a refundable tax credit for anyone who doesn't have an offer of coverage through their employer.
In Ohio, Medicaid surpassed cost projections by nearly $1.5 billion in the first 18 months after expansion.
All this reveals how little control states have over Medicaid.
The co-mingling of finances and rule-making in programs like Medicaid has split accountability between state and federal authorities, with dismal results.
The Supreme Court’s ruling in Burwell might have saved subsidies on federal exchanges, but it didn’t fix the ACA’s many problems and it certainly will not lower the cost of coverage.
Instead, premiums have gone up since the passage of the ACA—by some estimates, the increase in national health spending under Obamacare will amount to an average premium increase for a family of four of $7,450.
It’s enough, now, for Congress to express a desire for a policy outcome and leave the details to an unelected bureaucracy—even when those details involve billions of dollars in taxes and spending, strict mandates and penalties, and government control over vast swaths of the economy.
You cannot vote the bureaucrats out of office, after all, and yet their administrative edicts 'shall be obeyed, observed, and kept as though they were made by act of Parliament.'