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The (un?)intended consequences of the Supreme Court ruling on healthcare

Posted by Charles II on June 29, 2012

Looking for the poison pill in the healthcare decision. As mentioned in comments below, Paul Santos of Salon pointed out that Roberts rather obviously switched in mid-stream from voting to strike down the ACA to upholding it. What happened? Surely Roberts is unrelentingly hostile to universal healthcare. So, are there consequences to his vote that will only become clear in years to come?

Kevin Russell, Scotusblog:

Starting to think about the potential collateral consequences of the health care ruling, I think it is very likely that one of its major impacts will be to revive claims that several significant civil rights statutes, enacted under Congress’s Spending Power, are unconstitutional.

In the health care decision, the Court held that Congress exceeded its Spending Clause authority by forcing states into an all-or-nothing choice by threatening to revoke all of their Medicaid funding if they did not participate in the Medicaid expansion. A decade or so ago, several states made similar challenges to a number of important civil rights statutes that condition receipt of federal funds on the state’s agreement to abide by non-discrimination principles in the federally funded programs.

All of these challenges failed. But it seems likely that many will now be revived.

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In that same vein, Erwin Chemerinsky:

Second, the Court struck down the penalty on states that do not comply with the increased requirements for Medicaid coverage. The Court said that this was unduly coercive. But no state has to participate in Medicaid. It may be a difficult choice to turn down federal money, but there is a difference between facing a hard choice and being coerced. Moreover, the Court offered no criteria for how to determine when strings on grants become too coercive and this will open the door to challenges to many federal programs.

Darshak Sangavi:

When one understands that the ACA’s real impact will derive from its expansion of Medicaid, the Supreme Court’s decision seems more worrisome. By limiting the federal government’s power to expand Medicaid in many states, the Supreme Court has seriously damaged the liberal dream of universal health coverage. As I wrote last fall, almost half of all people who qualify for free health insurance never sign up, especially in the Southern states where the highest number of uninsured people live. That’s not because inhabitants are lazy; it’s because those states create all kinds of barriers to Medicaid enrollment, since they have to assume some of the costs…

3 Responses to “The (un?)intended consequences of the Supreme Court ruling on healthcare”

  1. Phoenix Woman said

    “By limiting the federal government’s power to expand Medicaid in many states, the Supreme Court has seriously damaged the liberal dream of universal health coverage.”

    When Medicaid was first enacted, a number of states balked at it. Then the hospital lobby got involved.

    I don’t think that there are any hidden poison pills, for the simple reason that Roberts seems to have done such a sharp 180 so late in the process that it surprised his normal partners in crime Scalia et al.

    • Charles II said

      In the old Confederacy, they would rather stick it to poor people. As an article that I read recently showed, in Massachusetts, the number of additional people covered by Robamacare closely tracked the number of increased Medicaid recipients (although there was probably a just-as-important decline in underinsured).

      I don’t know what Roberts’ U-turn meant. But, as the last 20 years shows, it pays to be paranoid.

      • jo6pac said

        Yep, paranoid is good as I’ve been wondering around the inter tubes this was a brilliant move by Roberts. I’m sure it will come out in the coming weeks as people look down into what this really means besides the bat sh*& crazy peoples heads exploded. That was worth it but in the end Main Street always pays the price.

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