26 states challenged a federal expansion under health care reform . The justices are divided on ideological grounds on the issue . The issue touches on the legal question of federal and state powers . The states could instead abandon their participation in the program , but they say that would be a financial , social and political catastrophe -- one that they can not realistically accept . The high court debate on Medicaid concludes a series of health care reform cases .
26 states challenged a federal expansion under health care reform . The justices are divided on ideological grounds on the issue . The issue touches on the legal question of federal and state powers . The high court debate on Medicaid concludes a series of health care reform cases .