The Medicaid expansion is not such a good deal for states or the poor.

In the wake of the Supreme Court decision, states should not rush to expand eligibility for Medicaid. They cannot be certain that the federal support promised in the Patient Protection and Affordable Care Act will remain available, and a better deal might be possible after the election. Adding millions more to Medicaid rolls will exacerbate existing problems of access to providers. A more humane policy would give everyone--even the poor --a choice of health plans.