States Argue That Health Reform Law’s Medicaid Expansion Is Coercive
On Tuesday, the 26 states participating in the lawsuit against the federal health reform law filed a filed a brief with the Supreme Court, arguing that the overhaul's Medicaid expansion coerces states to participate in the program, Politico reports (Haberkorn, Politico, 1/10).
The reform law expands Medicaid eligibility to include U.S. residents with incomes at or below 133% of the federal poverty level. If states do not expand eligibility, they could lose all federal funding for the program.
Details of Brief
According to the brief, the reform law does not consider alternatives if a state chooses to opt out of Medicaid because of the expansion (Baker, "Healthwatch," The Hill, 1/10). The brief notes, "[N]o state is exempt from the massive penalty ... and so Congress did not even contemplate the possibility of a state opting out of Medicaid" (Politico, 1/10).
The brief continues that while the law "purports to leave states' participation in Medicaid nominally voluntary, multiple aspects of the [law] evince Congress' keen awareness that, in fact, no state will be able to reject its new terms and withdraw from the program."
The states also noted in the filing that the law requires individuals eligible for Medicaid who attempt to purchase coverage through a health insurance exchange to be automatically enrolled in Medicaid instead. They argued that the provision also assumes that Medicaid is no longer voluntary for states.
Obama Administration Response
An Obama administration official responded that no federal court has agreed with the states' Medicaid argument.
The official said, "After months of litigation and hearings, not a single judge agreed with the claim that Congress couldn't expand Medicaid," adding, "We are confident this trend will continue" in the Supreme Court ("Healthwatch," The Hill, 1/10).
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