One of the features of the Affordable Care Act (aka Obamacare) was the Medicaid Expansion provision that enabled those people who were too poor to qualify for the tax subsidies of the main plan but not poor enough to qualify for the standard Medicaid to be able to get access to health care. However the US Supreme Court ruled that while Obamacare was constitutional, states could choose not to accept the Medicaid provision and many Republican controlled states refused to do so because of their ideological opposition to Obamacare, even though it was almost cost-free for them, since the federal government would pay the entire cost for the first few years and almost the entire cost subsequently. Thus the poor in their states were sacrificed because of the Republicans’ hatred for anything associated with Obamacare.
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