The States and Medicaid

[True Federalist (진정한 연방 주의자)]

State participation in Medicaid is voluntary.  All that would happen if a State refused to pay its share is the Feds wouldn't pay their share either and Medicaid would cease to operate in that State.  Of course, the economic impact of such a decision is such that it is highly unlikely a State would ever choose to not participate, leaving in question whether their participation truly is voluntary.

[True Federalist (진정한 연방 주의자)]

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.