Skip to comments.Obamacare Medicaid Expansion Seems Long Shot at SCOTUS
Posted on 03/28/2012 1:54:05 PM PDT by Servant of the Cross
Its a testament to Paul Clements brilliant advocacy that reporters and spectators left the courtroom feeling less sure of a win for the federal government. Medicaid expansion was easily the hardest of the four issues he had to argue both the lower courts previously had rejected the states premise and he seemed to provide compelling evidence that coercion may be at play here.
Justice Kagan hardly let the word coercion leave Mr. Clements mouth before she hit him with a very blunt question: Why is a big gift coercive?
Therein lies the major distinction at the heart of the Medicaid expansion battle. Is it really a gift? Or is it an offer the states cant refuse, as Justice Scalia quoting Vito Corleone said?
Mr. Clement charged that the Medicaid expansion presented an unconstitutional breach of the principles of federalism. He argued that the states had no choice considering that the program in question is so big, and that the states must accept new funding to cover new enrollees or risk losing all federal funding for preexisting Medicaid enrollees.
Justice Breyer then jumped into the fray, arguing that the states wouldnt lose that old Medicaid funding for sure; rather, Congress said that states could lose that funding at the discretion of the Secretary of Health and Human Services. This is familiar language, he said, and the Court has never had reason to strike it down before now.
Mr. Clement pushed back, noting that the government has had every opportunity to say, Fear not, states, if you dont want the new money, then thats all youll lose. Yet they didnt, and the fact of this powers existence is inherently coercive.
Justice Sotomayor didnt care for the idea that granting the states more of the federal governments money also entitled the states to a greater say in how that money was used. Chief Justice Roberts noted that since the New Deal era, the states have become more dependent on the feds. Now, suddenly, theyre apprehensive about that dependence?
The Chief Justice also wished to know what was coercive: the huge amount of money the federal government was offering, or the old Medicaid money they were taking away?
Mr. Clement said both: no one in Congress wanted the states to refuse the new money and end the old program. Thus, they designed the terms in such a way that the states had no choice but to comply.
Interestingly, the Justices found the debate so engrossing that they allowed it to continue for an additional fifteen minutes. Those who said this would be an easy argument for them and I admit, I may have been in that crowd were very wrong.
Donald Verrilli then approached the bar again, and almost immediately, Justice Scalia asked, What did we mean when the Court said coercion could exist. The Chief Justice, too, pushed hard for an example. Mr. Verrilli stumbled about and never gave a specific example, prompting Justice Scalia to remark, I couldnt think of one, so Im not blaming you for thinking of one either.
Talk then turned to the power for the Secretary to revoke preexisting Medicaid funding. Chief Justice Roberts wanted to know if it was common for an unrelated threat to be made in association with new funding. Mr. Verrilli cited an example of one in Arizona.
Justice Kagan then did as she had yesterday, effectually making one of Mr. Verrillis points for him. She noted that the Secretary may have this power, but she doesnt want to use it, as it would take away healthcare for poor, ill people. Thus, shell sit down with the states, theyll work out the kinks they dont like in the plan, and they wont lose their funding. This is in direct contrast with Mr. Clements argument that simply possessing that power is coercive.
However, Chief Justice Roberts made a key distinction that hinted at his willingness to deem the expansion coercive. He noted the fiscal reality that the government may revoke some of their now-promised Medicaid funding in the future. At the moment, the states are only on the hook for 10% of the new Medicaid funding. But he postulated that in the future, budgetary constraints on Congress could lead them to take away more of that funding, thereby leaving the states on the hook for perhaps 20% of those costs.
He then turned to the relevant precedent, South Dakota v. Dole, and pointed out that the federal funding South Dakota was suing for was just 7% of their highway funding. Its a trivial amount, especially when compared to the amount at stake with Medicaid.
The Justices seemed less skeptical of the coercion charge than previously anticipated. Even Justice Kennedy noted that the states had no real choice but to accept the money. Its hard to imagine theyll use this as the defining limit of the coercion test laid out in Dole. But its certainly not impossible.
Everything that the Rats do is “coercive”.
Kagan has her head so far up owebama’s arse she can see harry reid’s feet.
After this it will be a cold day in hell before they ever try and slide this sort of shuck-and-jive through in a 2700 page bill again.
The use of voluntary matching funds to coerce states to adopt federal programs that the Feds’ don’t have authority to implement directly needs to stop.
The funds for all such programs should be apportioned fairly to all states whether they participate or not.
It is no secret that blackmail and extortion are the Federal Government’s normal mode of operation.
Wow! The federal gummint is SO generous with our money. So generous that they take it from us at gunpoint and then make us do what they want to get it back.
The wise Latina needs to understand: it isn't "the federal government's money"; the money belongs to the people. Earned by the people. Why the HELL shouldn't they have a say as to how it is used? WTF kind of reasoning is THAT for a "justice"?
They have had the briefs long enough to have an opinion. The oral arguments are legal theater. That being said, I hope Kennedy is thinking straight these days.
“Fear not, states, if you dont want the new money, then thats all youll lose.
That’s misleading. It’s not exactly “new” money. For some states it could be, when there’s a net redistribution of funds to their state from others. But in most cases, theoretically at least, it’s their own money they’re being led around on a leash to earn back. The feds tax their citizens, then make the governments stand up and beg to get it back.
This is at the very heart of our problems: that Democrats see money taken from taxpayers as a "gift" to those who get the money.
“Justice Sotomayor didnt care for the idea that granting the states more of the federal governments money also entitled the states to a greater say in how that money was used.”
What money did the federal government ever earn? Maybe from the interest earned on the assets the federal reserve system stole from the people. Or from the sale of public lands it stole from the people. Or any number of charges for services paid for by money stolen from the people.
Wish someone would tell them about what happened in Texas when we didn’t happen to like what HHS was “giving” us.
Many thanks...the author is not only well versed in the subject, but she can write a cogent, articulate paragraph..