Yes it is a moot point, because the states are chained by golden handcuffs.
Looks like the handcuffs have been loosened by the Obamacare case.
And ironically the expansion of health care to those who can't afford it may have been scuttled, while those who can afford it must get insurance. It seems exactly backwards from the original goals of the act.
This aspect of the SCOTUS decision just blows my mind away. What the feds giveth, the feds cannot taketh away, if the state recipients don't dance to its tune. We have another fertile area for future litigation it seems, since such a standard is perforce fuzzy in its application.
