The Supreme Court's recent ruling on Medicaid is extremely confusing, even for people who pretend to know what they're talking about. So, for those of you who want to know why the ruling undermines the Affordable Care Act but feel too bogged down by the details, here’s a little summary:

Many sources differ on some of the basic facts of the Affordable Care Act and the new provisions laid out by SCOTUS. "Under the law," Noam Levey of the Los Angeles Times writes, "the federal government plans to spend nearly $1 trillion over the next decade to help states cover all Americans who make less than 138% of the poverty line, or about $15,400." That seems fact-ish. But, then, The Wall Street Journal's blogger Anna Wilde Mathews writes, "The Supreme Court's decision throws into question a key one: the growth of Medicaid to include everyone making incomes up to 133% of the federal poverty level."

How is anyone supposed to know what the hell is going on when credible sources relate competing "facts?" (As it turns out, by the way, the WSJ blogger was right, according to the Kaiser Family Foundation). Here’s the gist:

The Supreme Court upheld some of the most popular parts of the Affordable Care Act: children can stay on their parents' health plans for more time and pre-existing conditions will not disqualify anyone from receiving coverage. That’s news for celebration. But, as of now, states do not have to expand Medicaid to provide free coverage for the poor. That is, they can opt out of that ACA provision without penalties.

|  Related: Supreme Court Upholds Affordable Care Act, Just As I Said They Would  |

A number of liberal states, like California, Illinois and Maryland will offer all of their residents coverage in 2014, which is good news for people who, you know, want health care.

But—and this is a big but—some conservative states like Florida, Texas, Nevada, Louisiana and Wisconsin will opt out of the massive Medicaid expansion, leaving a coverage donut hole, raising the questions: what and why?

All states are currently required to cover poor children, but not necessarily their parents. As of 2009, there were 17 states that only extended coverage to working parents making less than half of the federal poverty line. 45 states refused free or subsidized coverage to all childless adults.

ACA was intended to extend coverage to these people, some 17 million people. Now, however, some states see Medicaid expansion as an unnecessary and unwanted cost. After 2014, the federal government will cover 100% of the Medicaid extension costs. By 2020, that will drop to 90%, meaning billions of dollars in health care costs for states, which many conservative governors are wont to accept.

Here's the irony of it all: the courts upheld a provision in the ACA that guarantees healthcare to middle-income citizens through new insurance exchanges. But, by rejecting the Medicaid expansion money, states would be denying health care to the very poor. Hence the donut hole.

This undermines the core of ACA, which was intended to provide Health Care for any and everybody. And now states don't have to do that. They can keep on keeping on, offering coverage to poor kids and exchanges for middle-America. But the poorest of the poor are left out to dry, at least in health care wastelands like Texas.

Should your state refuse the funds? Tell us why or why not in the comment section below.
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