The Supreme Court ended its three-day series of healthcare reform hearings with an oral argument on whether the law's Medicaid expansion provision coerces states, according to a Politico report.
Twenty-six states argued that the law's Medicaid expansion will coerce states into complying by providing a large financial incentive to expand its program and threatening to pull funds if they do not. Under the expansion, states will have to expand Medicaid eligibility by 2014. The federal government will fund 100 percent of new Medicaid enrollees, gradually reducing to 90 percent in 2020 and beyond. States have the option to drop out of the program if they do not want to participate, but this would eliminate a huge source of healthcare funding for the poor.
Liberal justices seemed in favor of upholding the Medicaid expansion. Even Chief Justice John Roberts, a conservative, expressed some skepticism that the expansion is coercive to states, according to the report.
Justice Elena Kagan questioned how federal funding for states could be viewed as coercive. "Why is a big gift from the federal government a matter of coercion?" she said, according to the report. In addition, Justice Stephen Breyer asked Paul Clement, who represented the 26 states, where exactly in the law HHS threatens to pull all funds if a state does not expand its Medicaid program. Mr. Clement did not provide a specific line.
In contrast, Justice Samuel Alito asked Solicitor General Donald Verrilli, the representative of the federal government, why pushing states to expand Medicaid would not lead to similar incentives or threats to other state programs, such as education programs. This question suggests he may think Congress is overstepping its bounds with the expansion provision.
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Twenty-six states argued that the law's Medicaid expansion will coerce states into complying by providing a large financial incentive to expand its program and threatening to pull funds if they do not. Under the expansion, states will have to expand Medicaid eligibility by 2014. The federal government will fund 100 percent of new Medicaid enrollees, gradually reducing to 90 percent in 2020 and beyond. States have the option to drop out of the program if they do not want to participate, but this would eliminate a huge source of healthcare funding for the poor.
Liberal justices seemed in favor of upholding the Medicaid expansion. Even Chief Justice John Roberts, a conservative, expressed some skepticism that the expansion is coercive to states, according to the report.
Justice Elena Kagan questioned how federal funding for states could be viewed as coercive. "Why is a big gift from the federal government a matter of coercion?" she said, according to the report. In addition, Justice Stephen Breyer asked Paul Clement, who represented the 26 states, where exactly in the law HHS threatens to pull all funds if a state does not expand its Medicaid program. Mr. Clement did not provide a specific line.
In contrast, Justice Samuel Alito asked Solicitor General Donald Verrilli, the representative of the federal government, why pushing states to expand Medicaid would not lead to similar incentives or threats to other state programs, such as education programs. This question suggests he may think Congress is overstepping its bounds with the expansion provision.
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