Quick Take — Court Questions “Coercion”

The Supreme Court just adjourned — after running well over its one allotted hour — its argument on whether the Affordable Care Act’s Medicaid provisions unconstitutionally “coerce” the States into agreeing to a significant expansion of the state-federal Medicaid program.  It’s undisputed that Congress can put some restrictions on how recipients of federal money use it.  The question here is whether Medicaid funding is so important to the States that they had no choice but to agree to the Congress’s ACA Medicaid expansion.  If the States refused to expand their Medicaid programs as the ACA requires, they would have to leave the program and lose all federal Medicaid funding.  Here are two quick highlights from Dom at the Court:

  • The conservative justices, including Justice Kennedy, expressed concerned about whether states actually have a choice to accept the new Medicaid funding.  But they offered few clues about whether any coercion would be unconstitutional. (The question whether coercion is unconstitutional has never been decided by the Court).
  • The Court’s liberal wing appeared to reject the plaintiffs’ coercion argument on the facts and the law. 

Dom will be posting a short update on each of the arguments in advance of the 4 p.m. Q&A.  Stop by then for his analysis and to ask your questions!


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