[The Free Engineer]

It is not entirely clear to me what happens
If a state chooses not to participate and grow Medicaid.

It may be that the uninsured poor end those states end up being on the hook a considerable portion of what they “make” now in refundable tax credits in order to “pay” for their new “insurance” policies.

[concerned about politics]

It is not entirely clear to me what happens If a state chooses not to participate and grow Medicaid.

Medicaid will have to be rationed, or the people of the state will have to accept a massive tax increase to pay for it. The feds will only pay for it until everything is in force (I think the bill allowed 2 years?). That's when the states taxpayers get the shaft. They won't know about this "new crises" until after the election if no one tells them ( and you know the democrats will never waste a good manufactured crises. They didn't set the bill up this way for nothing. They'll save us all by coming in with a "new way" (single payer), because the "old way" (private insurance) didn't work.)

Americas health care system was working just fine until the left decided to break it and take it.