Tom Miller, AEI
The Medicaid portion of the decision also was a surprise to many observers. To update an old Justice Potter Stewart saying about pornography, the Court finally knew it had a case of unconstitutional coercion by the federal government when it saw one, here. This provides some incremental relief for debt-plagued state governments who will be able to just say no to Medicaid expansion, without risking loss of all federal matching funds for their old, pre-expansion Medicaid programs.
Miller heads the “Beyond Repeal and Replace” project at the American Enterprise Institute, and is co-author of “Why ObamaCare Is Wrong for Amerca”
The Supreme Court limited the power of the federal government to force compliance by penalizing states that refuse to go along. In essence, the court said that states could choose between the old version of Medicaid and the new one established by the law.
Chief Justice John G. Roberts Jr. said the federal government could not compel states to comply by cutting off all the federal money they receive for existing Medicaid programs.
When before has the court said it could theoretically put limits on the federal government's ability to make states do certain things, like expand Medicaid?
[There was a case] from the 30s called Steward Machine, which was a case involving the constitutionality of the Social Security Act. One of the challenges to the Social Security Act and the unemployment compensation it set up was that it coerced the states into participating. And the court rejected that claim. The court said, basically, we could imagine a situation in which the pressure imposed by Congress is so great as to turn into compulsion, but usually we think that states can take care of themselves. States have the power to tax. States have the sovereign ability to decide whether to participate in these programs. And that's the premise that we usually follow.
The second time the court considered this issue was a case in the 1980s, South Dakota vs. Dole, involving Congress' decision to attach a requirement to federal highway funds that states raise their drinking age to 21. And the court there said, again, we might imagine some situation which is coercive, but this isn't it.
That was a case where Congress was only taking away a little bit of money from states that didn't want to agree to the conditions.
But the principles articulated by the court suggest that there might well be other cases in which Congress is coercing states by attaching conditions to federal funds. Again, since the court has never held that before, it's a big deal. If you look over the last twenty-plus years since South Dakota vs. Dole, in the lower courts, a number of federal statutes have been challenged as coercing states by imposing conditions on federal funds. And the lower courts have basically uniformly rejected those claims largely on the grounds that although the court has suggested there might be some circumstances where the states could be coerced, the court had never found the states to be coerced. But now that talking point is gone. That argument is gone.
The Indiana Business Journal
Whether Indiana decides to opt out of the expansion—which was projected to cover an extra 500,000 Hoosiers, remains to be seen. But the ruling will give states more leverage with the federal government to create favorable arrangements, noted Mike Grubbs, a health care attorney at Barnes & Thornburg LLP in Indianapolis.
“It changes the states’ bargaining position from ‘boot on neck’ to traditional bargaining,” Grubbs said. He added, “If they choose to expand Medicaid, they don’t have to do it through traditional Medicaid. I think it’ll give more flexibility to the states in how they propose to do that.”
The Washington Post
What the Supreme Court said today was: States do not have to participate in that part of the law. If they want to leave their Medicaid program as is, there will not be a penalty. What was once a guaranteed insurance expansion is now left to the discretion of the states.
Professor Randy Barnett
The Constitution's limits on federal power live to fight another day. Chief Justice Robert's majority opinion that "the individual mandate cannot be upheld as an exercise of Congress’s power under the Commerce Clause" vindicates our claim that commerce power is limited, and that the individual mandate exceeded this power. Plus, the Court's ruling that Congress may not use existing Medicaid funding to coerce the states to accept new requirements is a victory for federalism.
The court ruled that states which do not expand eligibility will only have to forgo federal funds which are meant for the expansion, not all Medicaid.
ABC NEWS, THE NOTE
“Although many will be surprised that Chief Justice Roberts joined the Court’s progressive bloc to uphold the mandate, the far bigger surprise is that two members of that bloc-Justices Breyer and Kagan-joined the conservatives in holding that the Medicaid expansion exceeded Congress’s power,” says Stephen Vladeck, of American University Washington College of Law.” As a matter of precedent rather than politics, the Breyer and Kagan votes on Medicaid are likely to be far more significant going forward than the Roberts vote on the mandate,” he said.
Paul Clement, an attorney for the states called this part of the ruling a “significant victory” he said. “The states will have a chance to make the choice. They will no longer have the gun to their head.”
Renee M. Landers of Suffolk University Law school says the impact of today’s ruling, “could reduce the number of people who will be eligible for Medicaid because it is easier for the states to opt out.”