Administration submits brief on Medicaid expansion plans

The Obama administration filed a brief with the U.S. Supreme Court laying out its argument against the contention of 26 states that the healthcare reform law unconstitutionally coerces them to pull too much of the weight in extending coverage to 36 million Americans. While the fight about the law’s mandate that individuals buy health insurance has received the most attention in the legal battle, the Supreme Court also will review whether Congress exceeded its authority by significantly expanding Medicaid eligibility. Lawyers for the administration argue in the brief that Congress took steps to mitigate the burden by initially covering the costs and later providing additional federal assistance, and that any new burdens on state Medicaid programs will be “more than offset” by other cost reductions achieved by the reform law. The brief also rejects the states’ argument that they can’t realistically opt out of Medicaid because of the large size of the program. “However attractive the offer of federal Medicaid funding may be, the decision whether to accept it always belongs to the states,” the administration argues in the brief, describing the states’ opposing view as a reflection that their citizens “would hold them politically responsible” for either eliminating benefits or raising taxes to provide the coverage on their own. The court is scheduled to hear arguments in the healthcare challenge at the end of March, with the Medicaid question scheduled for March 28.