Bettin’ on SCOTUS, Part 5: Is the Medicaid Expansion Coercive?

May 4th, 2012 | Healthcare Reform

As a non-lawyer this was perhaps the most fascinating oral argument issue to review, as it involved the very core of the Constitution, the concept of federalism and what might more commonly be thought of as State’s Rights.  Both conservative justices and liberal Justices closely questioned both sides and the likely outcome seemed less clear than perhaps on the individual mandate question, where it seemed the Court was decidedly against it.  The thrust of argument of the 26 states suing the federal government  seems to be 1) that if the states are forced to spend this money on Medicaid expansion they do not have the money to spend on some other program and that the increased taxes collected by the federal government to fund Medicaid reduce the ability of the states to tax; 2) the legislation grants to the Secretary of HHS the right to withdraw ALL Medicaid funding if a state refuses to implement the expanded coverage requirements of PPACA; and 3) the Medicaid expansion is tied to the individual mandate, the latter of which is unconstitutional. .

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