States File Brief with Supreme Court Challenging Medicaid Expansion

Yesterday, 26 states filed a brief with the Supreme Court challenging the Medicaid expansion under the Affordable Care Act as unconstitutional. These states are asking the Supreme Court to make an unprecedented decision that could leave 10 million women without access to medical services and could put countless civil rights laws at risk.

The states claim that the Medicaid expansion is coercive because, given state budgetary constraints, states can’t really opt out of Medicaid so they are coerced into covering the expanded population and not cutting back on current eligibility rules. But states can opt out and at least two states – including the lead state on the Supreme Court challenge – have publically considered the possibility. If a state chooses to continue offering Medicaid and comply with the provisions of the Affordable Care Act because offering Medicaid is the best option to provide health care to the state residents, that isn’t coercion. That is proof that Medicaid works.

Medicaid works to provide healthcare to women, as detailed in an issue brief released a few days ago by the Kaiser Family Foundation.

Medicaid works to provide access to family planning services and maternity care – it works well enough to pay for 40% of births in the United States.  

Medicaid works to provide care to medical and supportive services for women with disabilities.

Medicaid works to improve access to physician visits, cancer screenings and prescription drugs.

Medicaid works to keep women from delaying care they need.

Starting in 2014, Medicaid will work to expand coverage to up to 10 million more women when eligibility is increased to 133% of the federal poverty level. The challenge to the Medicaid expansion puts access to health care at risk for these 10 million women.

We are confident that the law is constitutional – indeed no court has ever accepted the argument that the States are making. But, we are concerned that the Court nevertheless chose to consider the Medicaid challenge. If the Court surprises us and agrees with the 26 states, then more than the Medicaid expansion is at risk. For example, the Court could call into questions decades of civil rights law that is based on the right of the federal government to require states that accept federal dollars not to discriminate in programs funded by those dollars, making it more difficult for the federal government to protect individuals from discrimination in federally-funded programs.