Fed, states push and pull over Medicaid expansion

How the Affordable Care Act (ACA) connects Medicaid expansion to federal funding for state Medicaid programs has been subject to just a portion of the legal and political challenge as other parts of the health care law, like the individual coverage mandate or the requirement that contraceptive coverage be at no-cost to the consumer.

As Montana recently became the 29th state to expand its Medicaid program, other states like Florida, Texas and Kansas have voiced opposition to the government’s push for states to expand their Medicaid programs in order to receive funding for hospitals and doctors who treat low-income individuals.

Florida Gov. Rick Scott filed suit against the Obama administration on April 28, arguing the federal government is coercing his state to expand its Medicaid program by making hospital funding contingent on it.

The Associated Press (AP) reports that Scott believes the Supreme Court’s 2012 ruling in National Federation of Independent Business v. Sebelius that Congress does not have the constitutional power to link state Medicaid expansion with provision of full Medicaid funding applies to the Low-Income Pool (LIP) program, which gives special funding to Florida and several other states to provide care for low-income individuals. According to AP, legal analysts have said Scott’s new case against Obama administration may not be congruent with the 2012 ruling because Congress retains broad discretion over the optional LIP, which may not be an integral part of Medicaid.

The Agent’s Advantage recommends The New York Times and Kaiser Family Foundation for further reading about state-by-state Medicaid expansion.