Supreme Court's Medicaid ruling: 'A shift in kind, not merely degree'

One of the toughest currents—and ironically the most far-reaching insofar as coverage is concerned—is represented by the Medicaid expansion. Of the 32 million additional children and adults who will have insurance coverage when the Act is fully implemented, a full 16 million stand to be covered through a Medicaid expansion. The effect of this expansion is to reshape Medicaid from a program covering certain categories of the poor into one that offers universal public insurance for all non-elderly low income citizens and long-term legal residents living in poverty.