"It has largely skipped the national press’s attention — perhaps because of the presidential debate that evening — but a June 27 court ruling could have far-reaching negative consequences for U.S. health care and federalism. If [the] higher courts uphold it, the ruling will not only make conservative changes to state Medicaid programs difficult to impossible, but it could also permanently lock states into Obamacare’s Medicaid expansion to the able-bodied. …States like Georgia and Mississippi that spent the past year considering Medicaid expansion should view Boasberg’s ruling as a timely warning of the fiscal and legal perils awaiting should they acquiesce. The combination of much less flexibility for states regarding benefit packages, coupled with a potential inability to exit the Obamacare expansion, could turn Medicaid into a fiscal version of the Eagles’ “Hotel California” — states can check out any time they like, but they can never leave."