Legal Challenge To ACA Says All-Or-Nothing Medicaid Funding Coercive

"Help, help, I'm being oppressed!" That's the argument made by states that will be heard before the Supreme Court. As this article points out, under the new Affordable Care Act, the feds will pay all of the Medicaid costs between 2014 and 2020,

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"Help, help, I'm being oppressed!" That's the argument made by states that will be heard before the Supreme Court. As this article points out, under the new Affordable Care Act, the feds will pay all of the Medicaid costs between 2014 and 2020, then dropping to 95 percent in 2017 and then to 90 percent in 2020.

To put this into perspective, the federal government now pays between 50 and 83 percent of state Medicaid costs. The states who filed this lawsuit to try to overturn the ACA are saying it's too coercive to offer them all this new money:

WASHINGTON — A major issue in the Supreme Court battle over the new health care law is whether Congress can force states to make a huge expansion of Medicaid, to add millions of low-income people to the rolls.

States say the federal law is unconstitutionally coercive because all their Medicaid money would be at risk if they flout the new requirement.

The states’ argument has implications that go far beyond health care. It raises questions about Congress’s ability to attach conditions to federal grants to the states for other purposes, like education, transportation, law enforcement and protection of the environment.

The implications for the health care overhaul are also enormous. The Congressional Budget Office says that about half of the people expected to gain coverage under the new law — 16 million of the 31 million people — will get it through Medicaid.

The Obama administration denies coercion and says the terms of the deal are exceedingly generous to states.

The states’ argument has “no logical stopping point,” said Solicitor General Donald B. Verrilli Jr., who will defend the health care law at the Supreme Court next week. The states’ theory, he said, “would call into question not only the extension of Medicaid eligibility in the Affordable Care Act, but also every other requirement for participation in the Medicaid program, not to mention an unspecified number of other federal spending programs.”

Senator Charles E. Grassley, Republican of Iowa, a vocal critic of the new law, offered a similar assessment, saying that a ruling for the states could “bring into question” prior expansions of Medicaid and conditions attached to other federal money.

Medicaid is by far the largest grant program, accounting for more than 40 percent of all federal aid to state and local governments, according to the White House.

The health care law offers Medicaid to people with incomes up to 133 percent of the federal poverty level (up to $14,850 for an individual and $30,650 for a family of four). Some states, like Louisiana, expect Medicaid rolls to grow by more than one-third, as many uninsured adults without children gain coverage.

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