In 2009 and 2010 President Barack Obama and Health and Human Services Secretary Kathleen Sebelius designed and championed the largest expansion of the welfare state since the New Deal with little more than political force and broken promises. While the American people are forced to accept Obamacare until it can be repealed, the Supreme Court empowered states to accept or reject Obamacare’s Medicaid expansion. So far 20 states have said no.