When the U.S. Supreme Court ruled that each state had the right to accept or reject Medicaid expansion under the Affordable Care Act, I was 100 percent certain that North Carolina could not possibly be so stupid as to reject billions of dollars in federal funding to provided much needed medical care for poor citizens of N.C. What made it even more certain that N.C. would expand Medicaid is that N.C. citizens had already paid for this expansion and would continue to pay the same amount in federal taxes whether we accepted federal funds or not.