The implications for the healthcare overhaul are also enormous. The Congressional Budget Office says that about half of the people expected to gain coverage under the new law—16 million of the 31 million people—will get it through Medicaid. States say the federal law is unconstitutionally coercive because all their Medicaid money would be at risk if they flout the new requirement. The states' argument has implications that go far beyond healthcare. It raises questions about Congress's ability to attach conditions to federal grants to the states for other purposes.