Comments on: More on the SCOTUS Health Care Decision

By: Jared Bernstein

Jared Bernstein — Fri, 29 Jun 2012 23:01:15 +0000

The SCOTUS said the Feds can’t coerce with penalties if states don’t take the expansion…I don’t think your Schmedicaid idea fixes that. However, here’s a variation that might work. What if Schmedicaid had a tiny, fractional Medicaid program that came with an expansion that got you all the way to the ACA Mcaid + expansion levels. States that chose only to accept basic Schmed would be screwed relative to current policy so they’d have to accept Schmed+expansion.

By: Auros Harman

Auros Harman — Fri, 29 Jun 2012 22:47:21 +0000

Nobody’s ever doubted that the Feds could create a program in which they offer the states money to do something and set terms about what has to be done; as far as I can tell the Court is just saying that when you tinker with a program you can’t be that coercive about changing the deal. The problem with that logic is, from what I’ve read of the decision, it seems like even though the Feds are being disallowed from applying a stick to a modification of a program — leaving them only the carrot of funding the expansion — it seems like they could still legitimately pass a law that ends MedicAid entirely, and simultaneously institutes an “entirely new” program called SchmedicAid, which just so happens to have parameters identical to the old MedicAid plus the expansion. Am I misunderstanding this?

By: davesnyd

davesnyd — Thu, 28 Jun 2012 19:46:08 +0000

OK– having read both this post plus the Klein one you recommended, next question: how does this affect other situations where Congress uses withholding of funds to motivate State legislative actions?

I’m thinking of the threat of withholding highway construction funds being used to enforce speed limit, drinking age, and seat belt usage.

I don’t know whether there are other examples, too.