Medicaid, the Supreme Court, and the coersion theory.

Posted November, 15 2011 by arianne

Unless you’ve been sleeping under a rock (or perhaps in a tent down at Zucotti park) you’ve probably heard by now that the Supreme Court has decided to hear one of the cases challenging the health reform law.  Specifically, it will be looking at a few pieces of the law, including the requirement that everyone have insurance (individual mandate), and the Medicaid expansion.

Nobody was really surprised about the individual mandate bit, but taking up the Medicaid issue is one decision that has raised a number of eyebrows.  Basically, the issue at hand is that the Affordable Care Act (ACA) will expand Medicaid to cover adults who earn up to 138% of the Federal Poverty Level (around $15,000 per year) beginning in 2014.

States that don’t already cover these folks will have the entire cost of this expansion covered by the federal government for the first three years.  After that the state’s share will increase gradually until it reaches 10%.  While states can always choose not to expand their program, this could put them at risk of losing their exising Medicaid funding.  So opponents of this provision are saying that the possibility of losing a significant chunk of funding makes the whole thing some sort of coercive action on behalf of the federal government.

This “coersion theory” argument isn’t a new one, and has been brought up in a number of unrelated cases in lower courts.  But, a federal law has never actually been stricken down on these grounds and to do so could also call into question any number of other federal programs.  So, this issue is definitely one to watch.

For more on this, and other issues surrounding the recent Supreme Court decision the hear the ACA challenge, here are a few links from around the web: