In National Federation of Independent Business v.Sebelius 2012),the Supreme ruled that states do not have to expand their Medicaid coverage because

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The Supreme Court ruled that the provision in the Affordable Care Act that threatened states with a loss of existing federal funding for Medicaid if they did not expand their coverage was an impermissible coercion of the states, violating the Constitution's spending clause. Therefore, states do not have to expand their Medicaid coverage without risking their existing federal funding.

In National Federation of Independent Business V