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Implications of the Supreme Court's ACA Medicaid Decision

Published online by Cambridge University Press:  01 January 2021

Jane Perkins
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Extract

Congress implemented the Medicaid Act in 1965, acting pursuant to its Spending Clause authority to “provide for the…general Welfare.” Over time, the Act has been amended more than 50 times. Most recently, as part of the Patient Protection and Affordable Care Act (ACA), Congress required participating states to extend Medicaid eligibility to childless, non-disabled, and non-elderly adults with incomes below roughly 133% of the federal poverty level (referred to as childless adults).

Within hours of President Obama signing the ACA into law, four lawsuits were filed challenging the con-stitutionality of the ACA, including a case in Florida that eventually made its way to the Supreme Court as National Federal of Independent Business v. Sebelius (NFIB). As part of this case, officials from 26 states argued that Congress was improperly coercing them into participating in the Medicaid expansion.

Type
Supplement
Information
Journal of Law, Medicine & Ethics , Volume 41 , Issue S1 , Spring 2013 , pp. 77 - 79
Copyright
Copyright © American Society of Law, Medicine and Ethics 2013

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References

U.S. Const. art. I, § 8, cl.1; see Social Security Act Amendments of 1965, Title XIX, Pub. L. No. 89-97, § 121, 79 Stat. 286, 343-52 (1965).Google Scholar
Pub. L. No. 111-148, § 2001(a)(1), 124 Stat. 119 (March 23, 2010) (adding 42 U.S.C. § 1396a(a)(10)(A)(i)(VIII)). Initially, state coverage of the expansion group will be entirely federally funded; when state participation in funding is fully phased in by 2020, states will be responsible for 10% of the costs. See 42 U.S.C. § 1396d(y).Google Scholar
132 S. Ct. 2566 (2012).Google Scholar
Id., at 2630 (2012) (Ginsburg, J., dissenting) (emphasis is original).Google Scholar
430 U.S. 188, 193 (1977) (citation and internal quotation omitted).Google Scholar
132 S. Ct. at 2604.Google Scholar
Id., at 2603.Google Scholar
Id., at 2604.Google Scholar
Id. (citing Dole, 483 U.S. 203 (1987)).Google Scholar
132 S. Ct. at 2604.Google Scholar
Id. (citing Dole, 483 U.S. at 211).Google Scholar
Id., at 2605–06 (citing 42 U.S.C. § 1396a(a)(10)).Google Scholar
Id.Google Scholar
Id., at 2606 (citing Pennhurst State Sch. & Hosp. v. Halderman, 451 U.S. 1, 17 (1981)).Google Scholar
Id.Google Scholar
Id., at 2604–05 (citing 42 U.S.C. § 1396c); see also id., at 2604 (noting that states have developed “intricate statutory and regulatory regimes” over many decades to implement the existing Medicaid program).Google Scholar
Id., at 2606.Google Scholar
Id., at 2607 (citing 42 U.S.C. § 1303). Explicitly, the decision did not “affect the continued application of § 1396c to the existing Medicaid program.” Id.Google Scholar
For a detailed criticism of the opinion, see 132 S. Ct. at 2628–41 (Ginsburg, J., dissenting).Google Scholar
See 42 U.S.C. § 1396d(y)(1).Google Scholar
See 42 U.S.C. § 1396a(a)(13)(C) (primary care rate parity); id. at § 1396a(a)(10)(A)(i)(IX) (former foster coverage) (eff. Jan. 1, 2014); Id., at § 1396a(gg)(1) (maintenance of effort (MOE) requirement for recipients who are not children). The Governor of Maine's challenge the MOE requirement was summarily denied by the First Circuit. See Mayhew v. Sebelius, No. 12-2059 (1st Cir. filed Sept. 13, 2012).Google Scholar