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Is Medicaid the Real Target in Supreme Court Case?

March 26, 2012
Plain English Version

Lining up for health care Supreme Court hearing Reuters

The Affordable Health Care Act is now under review in the Supreme Court. The most controversial aspect is that all Americans will have to purchase health insurance by 2014.

Another part of the law is not mentioned often. It is the requirement that the states increase their Medicaid rolls to cover as many as 17 million more low-income people. Medicaid is free or low cost health care.

“Medicaid is the real sleeper issue,” said an attorney. If the court rules against the expansion of Medicaid, every change in the law since 1965 may be challenged.

On Wednesday, 26 states will argue that expanding Medicaid violates states’ rights. It is called the “coercion” argument. It forces the states to cover and pay for a new Medicaid program.

According to the lawyer for the states, the states have no real choice about participating. He said Congress should not be “free to use its spending power to coerce states into enforcing the federal government’s dictates.”

This argument has lost repeatedly in the lower courts.  Medicaid advocates were surprised the Supreme Court voted to hear the claim. One said, if the court struck down the expansion of Medicaid it would be, “a constitutional earthquake.”

Another advocate said, “If the Medicaid expansion is invalidated, it would mean the poorest of the poor will simply be shut our of America’s health care system.”

The Medicaid part of the law will cost the federal government nearly $800 billion over the next ten years.

The Los Angeles Times


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