Let's face it, the Republicans that are rejecting the Medicaid expansion are heroes! Justice Roberts is a hero for ruling the all or nothing Medicaid expansion unconstitutional. The Republican governors that have rejected the Medicaid expansion are allowing more people to enter the superior health care exchanges. For example, everybody that earns under 138% of the poverty level in Texas is now eligible for almost 100% subsidies on the exchange (as long as they are not eligible for Medicaid in Texas)...the exchange health insurance is superior to Medicaid. The people in states that expand Medicaid are FORCED to get on Medicaid if they make 137% of the poverty level. They can NOT get subsidies through the health care exchanges!
Yes, some people will not be covered due to states rejecting the Medicaid expansion, but would anybody really buy into Medicaid if they had the opportunity to buy private health insurance? We all know these people will still get health care, they just will not have efficient health care insurance! For example, a family of 4 living in a state that accepts the Medicaid expansion will be forced into Medicaid if they make $33,000, whereas in Texas that family would only have to pay 3.3% of their income for a subsidized health care exchange plan. Also, this might force the government to expand the health care exchanges, which would be better than expanding Medicaid! The key to Obamacare going forward is now the health care exchanges, not Medicaid expansion, due to Justice Robert's outstanding ruling!!
Here is where it gets tricky, employers are forced to pay fines if they do not offer health insurance or if their employees opt for a health care exchange plan, whereas they get a free pass if the employees sign up for Medicaid!! Obama and the Democrats wanted to give the employers a free pass with the Medicaid expansion!! Of course, this will force more employers to offer health insurance in states that reject the Medicaid expansion or they will pay fines.