States file briefs against Medicaid expansion

January 10, 2012

From an article by Jennifer Haberkorn, Politico

Twenty-six states on Tuesday asked the Supreme Court to overturn the health care reform law’s mandatory state expansion of the Medicaid program, a sleeper issue in the health care reform lawsuit that could determine how much leverage the federal government has with the states on any issue.

In their brief to the Supreme Court, the 26 states challenging the health care law say their option to quit the Medicaid program because they can’t afford the expansion is “illusory,” and they compare their options to those offered by a “pickpocket”: “The choice given [to] states is the equivalent of that offered by a pickpocket who takes a wallet and gives the true owner the ‘option’ of agreeing to certain conditions to get the wallet back or having it given to a stranger.”

The states, led by Florida, argue that the federal government can’t force them to expand the Medicaid program, which has operated as a partnership between the feds and the states, as part of the 2010 health reform law. They argue that the Medicaid expansion is possibly more coercive than the law’s individual mandate.

The states say that this time, the federal government has crossed the line and eliminated any semblance of a “choice,” so the Medicaid expansion is illegal.

The federal government argues that it is still a choice — even if it’s a difficult one. The Obama administration will have a chance to flesh out its argument in its own brief, which is due to the court by Feb. 10.

So far, the lower courts have agreed with the federal government. Both the Florida district court and the 11th Circuit Court that heard the 26 states’ lawsuit said the Medicaid expansion is valid.

Ron Pollack, executive director of Families USA, which supports the law and the Medicaid expansion, said the Medicaid question could have wider-reaching implications than whether the mandate to buy insurance is valid. A ruling for the states would be a “radical change in doctrine in what the federal government can do in respect with states on various initiatives,” he told POLITICO.

Note: The Children’s Mental Health Network will be at the Families USA conference next week. Follow our tweets for updates.

Jocelyn Guyer, co-executive director at the Georgetown Center for Children and Families and a senior researcher at the university’s health policy institute, said she’s confident the expansion will be upheld.

“The fact that all the states have taken up [Medicaid] reflects that it’s such a great deal,” she said. “We see this as highly unlikely, so we’re not spending a lot of time on it.”

Download the brief here

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