The U.S. Supreme Court might invalidate the 2010 Affordable Care Act (ACA), after three days of oral arguments. The five politically conservative justices' opposition centers around the individual mandate to buy health insurance, but the justices also look to be against ACA making states expand Medicaid.
Twenty-six states, all with Republican leadership, petitioned the court with the argument that Illinois and every other state's Medicaid expansion to help low-income adults amounts to coercion. Justice Antonin Scalia said the states have "no realistic choice" but to go along with an expanded Medicaid program.
Other justices, like President Barack Obama-appointed Elena Kagan, pointed out that the federal government will pay for Medicaid's expansion. States would only start paying in 2019, and even then it will be 10 percent of the cost for new patients. Kagan called the Medicaid expanded coverage a "big gift" from Washington to states. Many states, including Illinois, are in a fiscal bind and figuring out ways to cut Medicaid.