I have to admit that I don’t entirely understand the Supreme Court ruling today. Lots of people are concentrating on Roberts joining the “liberals”, which is semantically frustrating, but that’s not what I’m confused about.
This part about the expansion of Medicare is what I find perplexing, and perhaps someone can explain. If Congress is allowed to expand Medicare, but not allowed to coerce states into accepting the expansion by threatening to take away their funds, doesn’t that mean that Congress doesn’t have the power to amend legislation to meet the current need? What is it about Medicare that says states were guaranteed access to a certain flavor of coverage in perpetuity? Surely I’m missing something. Didn’t we do essentially the same thing with raising the drinking age?
It’s been a crazy week for the Supreme Court, for sure. I like the Maddow Blog’s breakdown. Short, simple, sweet. Though there’s tons more about it all over the place, including fellow economists Don Taylor of Duke (written here, on TV earlier link) and Harold Pollack of U Chicago at TNR.
Update: The Incidental Economist starts to get at my question, but not really. As does SCOTUSblog. Maybe I’m asking the wrong thing…
ERIN K. FLETCHER 
1. It’s an expansion of Medic-aid, not -are.
2. If Congress can block-grant Medicaid, then they can make alterations to distributions as needed, I suppose. But I doubt any Congress will take away current Medicaid funding.
Not sure if SCOTUSblog answers your question, but it’s a good explanation: http://www.scotusblog.com/2012/06/court-holds-that-states-have-choice-whether-to-join-medicaid-expansion/
Right, Medicaid, not Medicare. I always mix those up.