Medicaid mandates under Obamacare leave states with an unpleasant choice.

President Obama’s pick to head Medicare and Medicaid highlights the choice we face regarding Obamacare: repeal or rationed care.

Richard Epstein argues that ObamaCare would unconstitutionally coerce the states.

The Senate bill, which became the enacted version of Obamacare (in connection with the “reconciliation package”), was never intended to be final law — and it reads like it.

Those concerned that ObamaCare would produce an American health-care system that’s all-too-similar to Britain’s National Health Service will find no solace in President Obama’s nomination of Donald Berwick, Harvard professor and staunch advocate of the NHS, to head the Centers for Medicare and Medicaid Services.

“A June Health Affairs briefing on the implementation of the Patient Protection and Affordable Care Act (PPACA) showed just how deep the chasm is between many of Washington’s policy experts and ordinary Americans… While Washington is focused on convincing states to take federal government grants, ordinary Americans are worried about keeping existing coverage. While Washington policy experts wants to make the PPACA work, most American voters want it repealed.”

Ohio taxpayers will be on the hook for $1.45 billion in new Medicaid spending over 10 years as part of the unfunded mandates of ObamaCare. This new spending comes as the state faces a $8 billion budget shortfall over the next two years.

A new report by Blue Cross Blue Shield of Massachusetts reports that low-income state residents could see their premiums jump up, as ObamaCare’s Washington-driven regulations overturn existing state systems. “The report reveals that, despite the promised increase in federal funding, some Massachusetts residents might end up facing higher premiums.”

Ohio’s state government came out with a new estimate of the effects ObamaCare will have on it’s Medicaid program. The massive expansion will cost taxpayers $1.45 billion in the first 5 years after it starts, in 2014. Given that Medicaid is currently a budget-busting problem for most states, this huge new cost will crowd out other spending, or force tax increases.

Gov. Daniels gave a presentation demonstrating how ObamaCare would hurt state budgets and undo many innovative and successful state reforms already in place. Under ObamaCare, the Healthy Indianans Program, which covers the uninsured, will be replaced with a forced expansion of the state’s Medicaid program, which will provide inferior care and reduce flexibility for consumers.