For states, High Court's Medicaid ruling creates choices, makes waves

States are responding to the court's decision in varying ways. Some interpretations are leading states to pare back their existing Medicaid programs, according to the Wall Street Journal. Others find themselves in limbo.   

The Wall Street Journal: States Interpret Ruling To Cut Medicaid Now
Some cash-strapped states have seized on a section of the Supreme Court's health-law decision to pare their existing Medicaid programs, saying the ruling lifts the March 2010 law's ban on such cuts. The court, which upheld most of the law, struck down penalties for states choosing not to expand Medicaid. A few states are also trying to go farther, arguing that the ruling justifies cuts to their existing programs (Weaver and Radnofsky, 7/6).

Atlanta Journal Constitution: Georgia Health Care In Limbo
Georgia hospitals were depending on the health care law to ease the burden of treating hundreds of thousands of uninsured patients each year for free. But that relief may never come. While upholding the law, the U.S. Supreme Court ruled states could reject the massive expansion of the Medicaid program that is a cornerstone of the Patient Protection and Affordable Care Act. For hospitals, not expanding the health program for poor and low-income Georgians would mean having to treat almost as many uninsured patients as ever while facing significant cuts to their reimbursements (Williams and Teegardin, 7/8). 

Georgia Health News: ACA's Impact On Public Health: Changes And A Choice
Georgia Gov. Nathan Deal has taken a wait-and-see approach on Medicaid expansion. Georgia has about 2 million uninsured residents, or roughly 20 percent of the state's population. The more who get coverage, either through Medicaid or the health insurance exchanges that the ACA will create, the better for public health in the state, health experts say (Miller, 7/8).

Bloomberg: Hospital Bills Unpaid As S.C. Shuns Medicaid Expansion
Shirley Johnson gets her medical care at Palmetto Health Baptist hospital's emergency room in Columbia, South Carolina. ... Johnson, as a 49-year-old with no dependents, isn't eligible for Medicaid, the joint state-federal health program for the poor, which covers about 20 percent of the state's residents. And in two years, when President Barack Obama's health-care overhaul allows the expansion of Medicaid to cover 17 million more Americans, she may still be left behind (Newkirk and Selway, 7/9).

Greenville (S.C.) News: Clyburn Goes After Haley On Health Care
The state's top Democrat says Gov. Nikki Haley's rejection of expanded Medicaid under the federal Affordable Healthcare Act shows South Carolina's GOP leaders "don't seem to care" about the health of 700,000 South Carolinians. U.S. Rep. Jim Clyburn, the state's top elected Democrat and a top ranking Democrat in Congress, told GreenvilleOnline.com that he was not surprised at Haley's decision to reject the idea of creating a state-based insurance exchange under the new law, following a decision by the U.S. Supreme Court last week to uphold the law's constitutionality (Smith, 7/7). 

Richmond Times Dispatch: PolitiFact: McDonnell Claim About Medicaid Mandate Rated Pants On Fire
After the Supreme Court's ruling on the health care act, McDonnell repeatedly said states still face a "mandate" to take part in Medicaid expansion provisions in the law. Actually, the court's ruling had the opposite effect. It took away Washington's ability to punish states that don't take part in the expansion by eliminating their federal Medicaid subsidies. The court ruled states must have "a genuine choice" whether to take part in the expansion (Gorman, 7/8). 

Texas Tribune: Perry: TX Won't Implement Key Elements Of Health Reform
Texas will not expand Medicaid or establish a health insurance exchange, two major tenets of the federal health reform that the U.S. Supreme Court upheld last month, Gov. Rick Perry said in an early morning announcement. "I stand proudly with the growing chorus of governors who reject the Obamacare power grab," he said in a statement (Ramshaw, 7/9).

Houston Chronicle: Perry: No Medicaid Expansion, No State Health Exchange
Gov. Rick Perry says Texas has "no intention" of implementing a state health insurance exchange or expanding Medicaid now that the federal health care law has been upheld.  Here's an excerpt from his statement. His office says more will come Monday: "If anyone was in doubt, we in Texas have no intention to implement so-called state exchanges or to expand Medicaid under Obamacare, I will not be party to socializing healthcare and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government" (Fikac, 7/9).