During the Obamacare case before the Supreme Court, the Independence Institute argued that the law’s provisions forcing the states to expand Medicaid were unconstitutional. Neither the Constitution nor case law, we pointed out, permits the federal government to use federal spending programs to coerce the states.

Seven of the nine justices agreed with us, essentially adopting the arguments advanced in our brief.

As a result, the states may consider freely whether or not to accept additional federal funds for the Medicaid expansion. Accepting federal funds might seem to bring the states short-term fiscal benefits. But the fiscal risks of doing so are very great—perhaps eventual bankruptcy.

Dr. Linda Gorman, an economist, is director of the Independence Institute’s Health Care Policy Center. In this article, she explains in detail why state acceptance of the Obamacare Medicaid expansion would be a serious mistake.

Rob Natelson