The viability of the so-called “individual mandate” provision of the Patient Protection and Affordable Care Act received the most attention leading up to the Supreme Court’s decision last week in National Federation of Independent Business v. Sebelius. While the court’s decision upholding the individual mandate pursuant to Congress’ taxing powers surprised many, the court’s decision on the ACA’s expansion of Medicaid coverage (an issue generating less anticipatory analysis) was equally surprising and far reaching. First, the court ruled for the first time ever that Congress’ exercise of its spending clause powers was unconstitutionally coercive. Second, the court’s remedy for this violation was to give states the option of accepting or rejecting the coverage expansion and the corresponding federal funding. These two results could have dramatic implications for the ability of Congress to make changes to the nation’s many federally-funded programs that are jointly administered by federal and state governments, including other entitlement programs, education and transportation.
The Medicaid Expansion
As drafted by Congress and signed into law by the president, the ACA’s Medicaid expansion provisions dramatically increased the pool of individuals eligible to receive benefits. Starting in 2014, the ACA required all 50 states participating in the Medicaid program to cover people under the age of 65 with individual or family incomes up to 133 percent of the federal poverty level. Although the statute provided that the federal government would entirely pay for the expansion for the first three years, the federal government’s contribution would gradually reduce to 90 percent by 2020.
This content has been archived. It is available through our partners, LexisNexis® and Bloomberg Law.
To view this content, please continue to their sites.
Not a Lexis Subscriber?
Subscribe Now
Not a Bloomberg Law Subscriber?
Subscribe Now
LexisNexis® and Bloomberg Law are third party online distributors of the broad collection of current and archived versions of ALM's legal news publications. LexisNexis® and Bloomberg Law customers are able to access and use ALM's content, including content from the National Law Journal, The American Lawyer, Legaltech News, The New York Law Journal, and Corporate Counsel, as well as other sources of legal information.
For questions call 1-877-256-2472 or contact us at [email protected]
