Plaintiffs in Reform Law Case Affirm Opposition to Medicaid Expansion
In a brief filed with the Supreme Court on Monday, the 26 states challenging the constitutionality of the federal health reform law reiterated their opposition to the planned Medicaid expansion, The Hill's "Healthwatch" reports.
The states filed the final brief on the issue exactly two weeks before the high court begins to hear six hours of oral arguments over three days (Baker/Pecquet, "Healthwatch," The Hill, 3/12).
In the brief, the states renewed their argument that the overhaul forces them to extend Medicaid coverage to more individuals, undermining the long-running traditional state-federal partnership for the program. They also noted that they would risk losing all their federal Medicaid funds if they fail to participate in the expansion.
The Department of Justice's defense is that the federal government is not doing anything different by imposing conditions on money it allocates and that Congress reserves the right to alter, change or repeal the law that created the Medicaid program (Norman, CQ HealthBeat, 3/12).
States Could Continue To Oppose Law if Upheld
If the Supreme Court upholds the law, states still could take steps to oppose it, but they would undertake "major risks" by doing so, according to some experts, Politico reports.
It is "far-fetched across the board" that states would continue to actively oppose the law if it is upheld, Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities, said.
Larry Levitt, executive director of the Kaiser Initiative on Health Reform and Private Insurance at the Kaiser Family Foundation, said that state officials "would have to be willing to cause chaos in [their] state" if they continue to oppose the law after it has been upheld by the high court.
It is more likely that states opposing the law will do the bare minimum to meet its provisions, but also avoid HHS enforcement action, according to Politico.
HHS will need states to work closely with it to implement the law, though if a state actively opposes implementation, the department "may have trouble using its powers to bring it into line," Politico reports.
For instance, the federal government will set up health insurance exchanges in states that do not do so themselves, though for the exchange to operate successfully, a state will have to make changes to its Medicaid program to coordinate with the exchange. HHS could withhold Medicaid funding for states that do not comply, but "taking away coverage from thousands of people would accomplish precisely the opposite of the health care law's goals," Politico reports (Feder, Politico, 3/12).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.