Skip to comments.A Constitutional Opening - opting out of Medicaid mandate alternative to secession
Posted on 11/28/2012 5:09:42 AM PST by Cincinatus' Wife
...the Patient Protection and Affordable Care Act of 2010. Last June, in NFIB v.Sebelius, the Supreme Court gave the act a mixed bill of constitutional health. It upheld the individual mandate by saying that it was constitutional under Congresss taxing power. However,it also ruled that Congress could not compel the states to expand their Medicaid programs by threatening to cut off all Medicaid subsidies if they did not do so. Imposing onerous new requirements in a program that already represents such a large part of the states budgets that they cant afford to lose federal subsidies,the Court ruled, is unconstitutional. This was the first significant limitation on the federal governments power to use the strings attached to fiscal subsidiesgrantsin-aid,as they used to be knownin order to make states implement federal policies.
Nearly all federal welfare programs are joint operations of Congress and the states. Congress sets the standards,and if the states devise programs that meet those standards,Congress matches,or more than matches,what the states spend on them. (Obamacare, in fact, has a teaser introductory rate that the new consumer-protection bureaucrats would surely outlaw if it were done by a private corporation:It picks up 90 percent of the tab for the early years of the programan offer the states could not refuse, Congress assumed.)
The old-age-pension part of Social Security is unique in its status as a fully federal program. In 1937,the Supreme Court accepted this program as constitutional under the taxing power. On this reasoning,if Congress in 2010 had repealed the current Medicaid law altogether and created a fully federal health-insurance system,that would have been constitutionally permissible under the taxing power. But such a move was politically impossible for Harry Reid and Nancy Pelosi,so they instead retained the grant-in-aid device. That choice gave the Court an opportunity to revive a constitutional limitation....
(Excerpt) Read more at nationalreview.com ...
I would be interested in what would happen if a state formed an exchanged, and then ended it. It had a state exchange, so the Federal Goberment would not have the authority to set up a federal exchange.
and no taxes could reasonably be collected if the state exchange was abolished.
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