Several commentators have been highlighting an important but largely
overlooked aspect of yesterday’s Supreme Court health-care ruling: the decision
related to the expansion of Medicaid.
Under the Affordable Care Act, states are encouraged to expand Medicaid
coverage; to make it attractive for all states to do that, the federal
government will pay the full cost of the expansion for the first three years,
and will cover 90 percent of the cost after that.
But until yesterday’s ruling, there was a severe penalty: If states didn’t
expand their Medicaid coverage, the federal government would withhold all
Medicaid funding, even funding unrelated to the expansion. Seven of the nine
justices agreed that the government can’t do that.
Some commentators have worried that the ruling makes it likely that many
states will not participate in the expansion, leaving millions of Americans
still without health-care coverage. But on scotusblog today, Kevin Russell adds another concern: Yesterday’s court ruling, he writes,
may open the door to states suing to get out of other federal programs that
have carried similar penalties.
Among them, he writes: “Title IX (sex discrimination in federally funded
education programs), Title IV (race discrimination in any federally funded
program), and the Rehabilitation Act (disability discrimination in federally
funded programs).”
Russell concludes that it probably isn’t likely that the Supreme Court would
strike down those older laws. But, he adds, “I would not be surprised to see
some lower courts holding the statutes unconstitutional, and I would be shocked
if states did not ask them to do so.”
This article appears in Jun 27 – Jul 3, 2012.
