State AGs file brief supporting constitutionality of ACA and expansion of Medicaid

Twelve state attorneys general have filed an amicus brief with the Supreme Court in support of the constitutionality of the health reform law to significantly enlarge the Medicaid program. The brief urged the high court to support the landmark Patient Protection and Affordable Care Act (ACA).

At issue in the brief is whether Congress overstepped its authority by expanding Medicaid and by requiring the states to implement that expansion or forego federal funding.

Joining Oregon in this brief were the attorneys general of California, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maryland, Massachusetts, New Mexico, New York, and Vermont, and the governor of Washington.

The historic battle before the Supreme Court is little more than a month away and tends to fall along political party lines.

In August 2011, a divided United States Court of Appeals for the Eleventh Circuit ruled that parts of the ACA were unconstitutional but upheld other aspects of the law. The attorneys general of 26 states, led by Florida, and the National Federation of Independent Business, are challenging the ACA in the Supreme Court, which will hear oral arguments in the matter March 26, 27 and 28.

ACA’s Medicaid expansion is constitutional and so Congress has not overstepped its authority or "coerced" the states by enacting it, according to the state officials led by Oregon Attorney General John Kroger.

Medicaid has always been a cooperative partnership between the states and the federal government, and the ACA does nothing to change that, according to the brief.

In a cooperative state-federal program, the federal government establishes the program's core requirements and gives the states the freedom to establish their own programs within those requirements.

“The ACA's Medicaid expansion does not change that fundamental arrangement, and it is entirely consistent with the history of the program. While expanding Medicaid's basic eligibility standards, the ACA does not disturb the states' autonomy and freedom to experiment that has always been a hallmark of the program," the amicus brief said.

The health reform law enables states to substantially expand and improve health insurance coverage, and the Medicaid expansion is a critically important component of that. The ACA continues the tradition of state flexibility and experimentation that has been the hallmark of the program.

Also recently, organizations that support the states bringing the lawsuit against the administration have filed an amicus brief on the constitutionality of the individual mandate.

The Cato Institute, Pacific Legal Foundation, Competitive Enterprise Institute and 14 other organizations said in their brief filed Feb. 13 that the requirement that all individuals obtain health coverage exceeds Congress’s power to regulate interstate commerce.

Regulating non-economic activity, or the fact that many individuals do not choose to get health insurance, cannot be “necessary,” regardless of its economic effects, their brief stated.

The government paints not being insured as the activity of making an “economic decision” of how to finance health care services. The idea that probable future participation in the marketplace constitutes economic activity now goes far beyond existing precedent, according to the brief.

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