Adding millions of additional people into Medicaid, a program that has been struggling with access to care for the past forty-five years, is likely to result in worsening access for those who are currently enrolled. Expanding Medicaid makes these new Medicaid patients (some of whom already had private health insurance, by the way) dependent on government for their health care, and thus would expand the constituency for more government spending and higher taxes all while providing them inferior access to health care. Even with questions of finance aside, our government is assuming powers that belong with individuals, communities, and mediating institutions such as churches and other support networks.