Court’s Ruling on Medicaid May Alter Federal Program Landscape

As reported on National Public Radio earlier this month, Medicaid currently provides health care coverage for one out of every three American children. With the new expanded coverage under the Affordable Care Act that will take effect in 2014, millions of more Americans may become covered under Medicaid. However, as the Supreme Court makes its decision on the case challenging the new law, legal experts are wondering if the court’s decision may fundamentally alter not just Medicaid and the healthcare law, but the way the states interact with the federal government on many other programs.

Medicaid is a voluntary program, meaning that states are not required to participate in it, but they do receive federal funding if they choose to do so. The new expansion guidelines under the Affordable Care Act will require states to provide coverage to many more patients who currently do not qualify. Part of the challenge to the law is this expansion of coverage. The states challenging the law are saying that this is coercive and should not be allowed by the court.

If the Supreme Court agrees with the coercion argument, it may strike down the law as unconstitutional. However, there are other Federal programs that use a similar voluntary funding and requirement structure that may be vulnerable to such a ruling. Federal educational, child welfare and other programs may be jeopardized if the court declares the Medicaid expansion to be coercive. Though the court has heard arguments, it will not issue a ruling until sometime this summer.