In a little-noticed exchange Monday, conservative Supreme Court Chief Justice
John Roberts may have tipped his hand that he’s entertaining the possibility
that the health care law’s individual mandate can be upheld on a constitutional
basis that’s different from the one supporters and
opponents have made central to their arguments.
For over a year now, observers and experts have assumed that the court’s
final decision will hinge on the extent of Congress’ power to regulate
interstate commerce. But the justices could also upend that conventional wisdom,
and in a worrying sign for the plaintiffs on Monday, Roberts unexpectedly
highlighted one way they could do that.
In an exchange with a plaintiffs attorney, Roberts suggested he’s skeptical
that the mandate and its penalties can be treated separately and may have opened
the door to finding that Congress’ power to impose the mandate springs from its
broad taxing power.
“The idea that the mandate is something separate from whether you want to
call it a penalty or tax just doesn’t seem to make much sense,” Roberts said,
over strong objections from attorney Gregory Katsas. “It’s a command. A mandate
is a command. If there is nothing behind the command, it’s sort of, well what
happens if you don’t file the mandate? And the answer is nothing. It seems very
artificial to separate the punishment from the crime. … Why would you have a
requirement that is completely toothless? You know, buy insurance or else. Or
else what? Or else nothing.”
That wasn’t what the challengers wanted to hear. A key feature of their
argument is that the individual mandate is distinct from the fine the government
will assess on people who fail to purchase insurance. They say the case isn’t
about Congress’ power to tax or penalize people but rather about its power to
force people to take actions they may not want to take. Roberts dismissed this
distinction.
The question now is how far-reaching the implications of that dismissal are.
It’s possible that Roberts was linking the mandate and its enforcement mechanism
for the purpose of answering
a much narrower question — that it wasn’t a tip-of-the-hand at all. But if
the two measures are linked, then the court could easily conclude they both stem
from the same power, and give them the green light.
“Struck me too,” said Timothy Jost, a legal scholar and supporter of the
health care law, who has followed these arguments very closely. “This is a big
problem for the states’ Medicaid argument and might even support the federal
government’s argument that the mandate is an exercise of the taxing power.”
The states want to avoid that at all costs — the taxing power is far too
broad. In a written brief, attorneys for the state respondents noted, “The
federal government’s last ditch effort to abandon its earlier rhetoric and
defend the mandate as a tax fails for the simple reason that, regardless of its
enforcement mechanism, the mandate itself is not a tax.”
Roberts suggested Monday that distinguishing between the two might not be so
easy.
Randy Barnett, a constitutional scholar and one of the architects of the
legal challenge, isn’t concerned just yet. He thinks Roberts’ critique was
limited to the narrower subject of Monday’s arguments over whether the court has
the jurisdiction to rule on the merits of the case yet, given that nobody will
be assessed a fee for violating the mandate until 2015.
“The only thing I think Chief Justice Roberts was expressing resistance to
was our argument that the mandate was separate from the penalty for purposes of
the [Anti-Injunction Act],” Barnett said in an email. “That is only one of the
bases on which the AIA does not foreclose consideration on the merits. I don’t
think he was signaling anything at all about the constitutionality of the
mandate penalty, the subject of tomorrow’s argument. If he was, however, I
expect to get a much better sense of that tomorrow so we won’t have to wait long
to find out.”
Constitution,
HCR/SCOTUS,
Health Care,
Individual
Mandate, John
Roberts, Taxes
WASHINGTON -- Rick Santorum will make an appearance on the steps of the Supreme
Court on Monday, when the Court will commence three days of arguments as to
whether President Obama's health care overhaul is constitutional.
Santorum will speak to the press around midday, a campaign spokesman told The
Huffington Post.
For the last month, Santorum has made health care the central theme of his
campaign, charging that frontrunner Mitt Romney is "uniquely disqualified" from
running against Obama, because Romney passed a health care overhaul as governor
of Massachusetts that included a mandate to buy health insurance, like Obama's
law.
On Sunday night, Santorum
became angry and cursed at a New York Times reporter who he felt
had taken out of context his comment that Romney is "the worst Republican in the
country to put up against Barack Obama." Santorum told the reporter, Jeff
Zeleny, that he was "the worst Republican to run on the issue of Obamacare, and
that's what I was talking about."
As national attention turns to Obamacare, Santorum has an opportunity to
create momentum in the Republican presidential primary, heading into primary
contests in Wisconsin, Maryland and Washington, D.C. on April 3 (he is not on
the ballot in D.C.). He is expected only to be competitive in Wisconsin, and
even there it is an uphill battle, with
the only recent poll in the state showing Santorum down 13 points to Romney.
If Santorum loses all three contests on April 3, it may be hard for him to
survive through April to May. After the April 3 contests, there are no primaries
for three weeks, and on April 24, Santorum faces a difficult lineup of states,
with challenges in his home state of Pennsylvania and four other states voting
that day that are advantageous for Romney: New York, Connecticut, Delaware and
Rhode Island. In May, however, there are some primaries that favor him in
Southern states.
FROM: HUFFINGTON POST
DAY 2 MARCH 27, 2012
Obamacare Foes Score Points, But Kennedy's A Wild Card
Three of the most conservative justices on the U.S. Supreme Court hammered
the government’s top lawyer in oral arguments over the constitutionality of the
healthcare reform act today. But swing Justice Anthony Kennedy shifted from
hostile questions to apparent support for the government’s key position by the
end of the two-hour session.
The marathon session seemed to favor the challengers, if only because
U.S. Solicitor General Donald
Verrilli spent most of his time on the ropes. It’s always dangerous to
predict how a Supreme Court case will go based on oral arguments, however. No
one seemed to eliminate
the lightly-discussed argument that Congress had the power to pass the law under
its broad taxing authority.
“I think we won today — but that’s not how courts decide things,” said
Bill McCollum,
a partner with SNR Denton in
Washington and former
attorney general of Florida, which brought the case challenging the law on
behalf of 26 states. McCollum, who attended the arguments in the packed chambers
of the Supreme Court, said Kennedy appeared inclined to side against the
individual mandate “but he asked some probing questions of the state side that
might lead you to believe he could go the other way.”
Late in the session Kennedy mused that perhaps the health care market is
different from other markets and could require the sort of federal regulation
Congress enacted. “That’s my concern in the case,” Kennedy said.
Supreme Court litigator
Andrew Pincus with Mayer Brown faced a similar barrage of questions when he
argued for AT&T in the
closely watched
AT&T vs. Concepcion last year.
“Scalia asked three hostile questions right out of the box and the reporters
all wrote `Scalia sides with plaintiff lawyers,’” Pincus said. “Then he wrote
the opinion” awarding AT&T the win, he said.
The early going was certainly tough on the government’s top lawyer, facing
nine justices for the second day in a row. Chief Justice John Roberts peppered
Verrilli with questions about how the law compelling everybody to buy health
insurance was different than a law requiring people to buy cellular phones so
they can call 911 in an emergency, or broccoli. The Obama administration says
healthcare is unique because everybody will be a consumer sooner or later, but
Roberts didn’t agree, saying everybody uses emergency services and buys food,
too:
There’s this health care market. Everybody’s in it. So we can regulate
it, and we’re going to look at a particular serious problem, which is how
people pay for it. But next year, they can decide everybody’s in this
market, we’re going to look at a different problem now, and this is how
we’re going to regulate it. And we can compel people to do things — purchase
insurance, in this case. Something else in the next case, because you’ve —
we’ve accepted the argument that this is a market in which everybody
participates.
Justices Antonin Scalia and Samuel Alito also pressed relentlessly with
questions about what made healthcare different, and how they could define the
limits on Congressional power if they allow forced purchases of insurance. Alito
was particularly concerned about the subsidies embedded in the law that flow
from young, healthy citizens to older ones with bigger medical bills. He noted
that the average individual health policy costs $5,800 yet young people consume
less than a tenth of that each year, casting doubt on the government’s argument
that the law is necessary to prevent the uninsured from shoving their costs on
the insured.
“You can’t just justify this on the basis of their trying to shift their
costs off to other people, can you?” he said.
Verrilli said the young will get other benefits under the law, such as
guaranteed access to insurance, and Congress has imposed similar cross-subsidies
in other markets such as telephone service and milk.
Scalia, Alito and Roberts seemed either hostile to the mandate or at least
concerned about its breadth, and Justice Clarence Thomas, who asked no
questions, is assumed to be a skeptic as well. Alito, at one point, delivered a
“question” that sounded more like a brief for the challengers:
The reason why there is cost shifting is because the government has
mandated that. It has required hospitals to provide emergency treatment, and
instead of paying for that through a tax which would be born by everybody,
it has required — it has set up a system in which the cost is
surreptitiously shifted to people who have health insurance and who pay
their bills when they go to the hospital.
But the challengers need five votes and Justice Anthony Kennedy didn’t offer
them much support. He, too, peppered the government lawyer with questions
including where the limit lay on Congress’s power to regulate commerce.
Your question is whether or not there are any limits on the Commerce
Clause. Can you identify for us some limits on the Commerce Clause?
Verrilli proposed a test which would leave “forced purchases of commodities”
unconstitutional but allow for Congress to dictate the method of payment — in
this case insurance for healthcare costs that are unpredictable and can
overwhelm people who aren’t financially prepared for them. That seemed to
satisfy Kennedy, who toward the end of the arguments said:
I think it is true that if most questions in life are matters of degree,
in the insurance and health care world, both markets — stipulate two markets
— the young person who is uninsured is uniquely proximately very close to
affecting the rates of insurance and the costs of providing medical care in
a way that is not true in other industries. That’s my concern in the case.
It would be dangerous to predict how Kennedy will vote in this case, said
M. Miller Baker, a veteran
Supreme Court litigator with McDermott Will & Emery in Washington.
Jones Day attorney Michael Carvin,
representing the the National Federation of
Independent Business, tried to appeal to Kennedy by comparing what the law
does to individuals with federal laws Kennedy has voted to strike down that took
away powers that belong to the states.
“Kennedy could come down either way on this,” Baker said. “There will be
uncertainty up until the end.”
None of the justices seemed concerned about the tax question, perhaps because
it was discussed exhaustively yesterday and the Obama administration was forced
to concede that it considered the penalty a tax for some purposes and not for
others. McCollum said there are other good reasons for the government to go
lightly on this one:
Paul Clement, arguing for the states, said the penalty might be considered a
“direct tax,” which under the Constitution must be apportioned among the states.
The only reason the federal income tax is exempt from this requirement is
because of a constitutional amendment.
The argument that the entire law can fall under Congress’s taxing authority
“is lost and I think the reason it’s lost is because not even Breyer and
Ginsberg believe in it,” McCollum said.
If the day went badly for the government’s top lawyer, that may be because
the case presents fiendishly complex questions of law and the philosophy of
government.
CNN legal analyst Jeffrey Toobin said the arguments were a “train wreck for
the Obama administration” and said Verrilli wasn’t prepared. Baker disagreed.
“Don Verilli’s doing something unprecedented –he’s arguing three days in a row
before the Supreme Court,” Baker told me. “When somebody else does that, they’ll
be in a position to critique.”
FRON:
http://www.forbes.com/sites/danielfisher/2012/03/27/justices-hammer-government-on-obamacare-mandate/
Today, March 27, 2012, the Supreme Court will hear two hours of oral argument
concerning the constitutionality of the individual mandate. The individual
mandate is the essential component of ObamaCare. It requires millions of
Americans to buy and indefinitely maintain health insurance or face annual
penalties.
The individual mandate marks the first time in the 220-plus year history of
our Constitutional form of government that Congress has required American
citizens to purchase a product (in this situation, health insurance) from a
private company simply because they are American citizens. Previously, Congress
provided us with incentives to buy certain products; it did not
require us to make those purchases. For example, Congress provided extra
money toward the purchase of a new car via the "Cash for Clunkers" program if we
chose to buy a new car, but Congress did not require anyone to buy a
new car.
The principle behind the individual mandate – that Congress can compel
Americans to purchase a product – is a game changer for our country. Should the
Supreme Court uphold this bold assertion of power, the Court would be giving
Congress virtually unlimited power under the Commerce Clause. From then on,
Congress could tell us what to buy and what not to buy (no matter the product);
if we refused, we would be hit with annual penalties.
This is not mere speculation. It is the position being advanced by the
federal government. During oral argument in a federal court in Pennsylvania in
another ObamaCare case, the federal government's attorney acknowledged to the
judge that, under the government's theory of the Commerce Clause, if Congress
determined that following the adage "an apple a day keeps the doctor away" would
improve Americans' health, then Congress would be within its Commerce Clause
power to order Americans to purchase apples. Further, the government's attorney
did not, and could not, name any requirement to purchase a commodity from a
private company that Congress would lack the power to enact.
Because the broad expansion of federal power underlying the individual
mandate would, if accepted, lead to a virtually unlimited power for Congress, it
is critically important that the Supreme Court invalidate the individual mandate
(as well as the entire ObamaCare law). As the Supreme Court haS
said repeatedly, the Constitution itself illustrates that Congress's power
under the Commerce Clause has limits. There are no limits, however, to
Congress's power under the federal government's view of the Commerce Clause.
Indeed, should the individual mandate be upheld by the Supreme Court, our
nation and system of government will be forever changed. Although the
Constitution deliberately divides power among the various branches and levels of
government so that no single individual or entity may wield unlimited power,
acceptance of the federal government's radical view of the Commerce Clause would
fundamentally alter the constitutional balance of power.
For more information about the options the Court has in resolving the
ObamaCare case, read my previous post
here.
The American Center for Law & Justice ("ACLJ") filed an amicus brief on the
individual mandate issue on behalf of itself, 119 Members of the United
States Congress, and more than 144,000 supporters of the ACLJ's efforts to
overturn ObamaCare. You can access that brief
here.
The ACLJ also filed its own challenge to ObamaCare and the individual
mandate. That case is pending at the Supreme Court. You can access information
about that case
here and
here.
The audiotape of the individual mandate oral argument will be available this
afternoon on the Supreme Court's website by 2:00 p.m. eastern time. You can
access the Court's website
here.
3.27.2012 Update:
During oral argument today, a number of Justices focused on the main problem
with the individual mandate: that, should the mandate be upheld, it would give
Congress unlimited power under the Commerce Clause and permit Congress to place
additional mandates on American citizens to purchase other products from private
companies or face annual penalties. Up until now, the Supreme Court has
recognized that Congress’s power under the Commerce Clause has limits. The
federal government today, as in the other ObamaCare cases, was unable to
articulate any true limits to Congress’s powers should the individual mandate be
upheld.
FROM:
http://aclj.org/obamacare/day-two-supreme-court-obamacare-argument-individual-mandate
DAY 3 -[ MARCH 28, 2012
Supreme Court closes historic ObamaCare arguments, as public awaits verdict
The Supreme Court on Wednesday wrapped up its exhaustive three-day session
which will determine the fate of the federal health care overhaul, ending with
what is arguably the most consequential question of the case -- if the
individual mandate is struck down, does the law survive?
The nature of questioning over the last few days signaled several judges have
serious doubts about the law. But they hardly indicated which way the
often-divided court would rule, with a decision expected by summer.
significant domestic policy achievement is a blockbuster. On the final day of
arguments, the gravity of the decision was evident, as justices struggled over
what to do with the rest of the Affordable Care Act if they also rule that its
central provision is out of bounds.
The question dealt with whether the entire health care law should stay or go
or be revised if the so-called individual mandate -- the requirement that
everyone buy health insurance -- is struck down. That, and a debate over the
law's Medicaid requirements, filled the last day of discussion in the landmark
hearings.
On the mandate, the justices broadly examined the other parts of the law
which the Obama administration was trying to save while its opponents asked for
complete repudiation. The discussion centered on what to do now with this case
but also on concerns over the proper role for the courts in interpreting what
Congress would want done with a law that's been changed from its original
version.
Justice Antonin Scalia raised concerns over the role of the courts in going
through this law and others line by line looking for parts to strike down.
"This is really a case of first impression," Scalia said. "I don't know
another case where we have been confronted with this decision. Can you take out
the heart of the act and leave everything else in place?"
To that end, Scalia made specific mention of a notorious provision of the
law, dubbed the "Cornhusker Kickback," which along with other sweeteners were
added to gain votes. That sort of legislative wheeling and dealing made it
difficult for some justices, especially Scalia, to see how the rest of the ACA
could survive without the mandate.
Some justices were open to keeping at least parts of the law, though.
Justice Ruth Bader Ginsburg likened it to a preference for a salvage
operation rather than a wrecking operation.
Ginsburg made note of many provisions in the ObamaCare law that have a modest
relationship to the controversial individual mandate and could work just fine
without the forced conscription of Americans onto health insurance rolls.
"I mean, it's a question of whether we say everything you did is no good, now
start from scratch, or to say, you know, there are many things in here that have
nothing to do, frankly, with the affordable healthcare, and there are some that
we think it's better to let Congress to decide whether it wants them in or out."
Echoing that view was Justice Elena Kagan, regarding the creation of local
health care exchanges to pool individuals into collectives that can bargain for
better rates.
She said sometimes half-a-loaf is better than no loaf and Congress "seems
like they want half a loaf."
Justice Sonia Sotomayor said she agreed with that sentiment, but lawyer Paul
Clement, arguing on behalf of the 26 states challenging the law, said that
sometimes half a loaf is worse and that the entire law should be set aside.
Clement cited a landmark campaign finance case that he said led to decades of
uncertainty and problems in political races. "This court looked at a statute
that tried to, in a coherent way, strike down limits on contributions and
closely related expenditures," Clement offered about the case Buckley v. Valeo.
"This court struck down the ban on expenditures, left the contribution ban in
place, and for four decades Congress has tried to fix what's left of the
statute, largely unsuccessfully."
The Obama administration's view is that only two parts of the law --
guaranteeing insurance for all people and at a rate affordable for all
participants -- should go down if the individual mandate is invalidated.
But Justice Anthony Kennedy expressed concern with that view, saying it might
end up worse for insurers who would still need to cover customers added on to
their roles.
"We would be exercising the judicial power if one act was stricken and the
others remained to impose a risk on insurance companies that Congress had never
intended," Kennedy said. "By reason of this court, we would have a new regime
that Congress did not provide for, did not consider. That, it seems to me, can
be argued at least to be a more extreme exercise of judicial power than to
strike the whole."
In trying to preserve those other parts of the law, Deputy Solicitor General
Edwin Kneedler noted portions of the ACA that are already in effect and made
mention of the provision allowing some adult children to obtain coverage through
their parents.
"It's going to bankrupt the insurance companies," Scalia shot back.
Sotomayor then fired off a line of argument from Tuesday's hearing saying she
thought 26-year-olds were healthy. A day earlier, the justices seemingly opposed
to the law raised concerns over the costs of the mandate on younger, more
healthy people.
Chief Justice John Roberts wondered "where is the sharp line" to draw in
determining what to keep and what to exclude.
Kneedler said that line is based on what Congress called essential elements
of the law.
The Court appointed lawyer Bartow Farr to defend the 11th Circuit's ruling
that the entire ACA should be upheld. He said the rest of the act still "serves
the central goals that Congress wanted" of near universal care at an affordable
cost.
But Kagan noted that based on the experiences of the states, Congress took
the Massachusetts model which tied the individual mandate to the rest of the
law.
The afternoon session focused on one specific provision of the law that
expands the Medicaid program providing health care to America's poor. The
federal-state partnership was created in 1965 and has expanded in the years
since. Clement, again arguing on behalf of the 26 states fighting the law, said
the expansion under the ACA was coercive, in part, because of the massive costs
involved and his contention that the states have no choice but to maintain
participation in the program.
Clement had barely finished his first sentence when Kagan immediately asked
him why it was coercive for the federal government to give billions of dollars
in additional aid to the states. "There are no matching funds requirements,
there are no extraneous conditions attached to it, it's just a boatload of
federal money for you to take and spend on poor people's healthcare," she
declared. "It doesn't sound coercive to me, I have to tell you."
To that, Clement said the government's money was still coercive because it
assumed the states would take the money and that Congress was leveraging their
prior participation in the program. Kagan pressed further with a hypothetical
asking Clement if he'd accept a lucrative job. He said it would depend on where
that money came from.
"Wow! Wow!" Kagan exclaimed in wonderment. "I'm offering you $10 million a
year to come work for me and you are saying this is anything but a great
choice?" Clement sharply replied, "Sure, if I told you, actually it came from my
own bank account."
That exchange served as an appetizer for a meal full of questions from the
Court's more liberal members peppering Clement. Sotomayor said she had troubles
with Clement's arguments on the funding matter: "We're going to say to the
federal government, the bigger the problem, the less your powers are. Because
once you give that much money, you can't structure the program the way you want.
... I don't see where to draw that line."
Perhaps the biggest issue of Clement's argument, if not the entire case, is
addressing whether the states are forced to accept the Medicaid expansion under
the threat of losing all preexisting Medicaid funding. Justice Stephen Breyer
was the most vocal against this idea saying it would be "unreasonable" for a
government official to actually take all money away from a state for
noncompliance with the new mandate.
Roberts didn't seem too keen on that argument, focusing instead on the
ability, however unlikely, of the Health and Human Services secretary to
withhold money.
"So why shouldn't we be concerned about the extent of authority that the
government is exercising, simply because they could do something less?" he
asked.
Solicitor General Don Verrilli, who was criticized in some quarters for his
performance Tuesday, said there was no significant history to suggest an HHS
secretary would withhold funds -- after all it's in everyone's interest to make
sure money is available for health services, a point backed by Kagan.
But Roberts likened the threat of possibly withholding funds to Dirty Harry,
saying it was unlikely the states would reply to Washington's demands with
"make-my-day" bravado.
For Justice Anthony Kennedy, the issue of compulsion raised concerns of
whether the central government was getting too involved in people's lives.
The close of the case also brought the curtain down on nearly six-and-a-half
hours of arguments over the health care law. Just before they adjourned, the two
lawyers offered a final plea to the court. Verrilli spoke first about the
problems of people not being able to afford health insurance.
"There is an important connection, a profound connection between that problem
and liberty. And I do think it's important that we not lose sight of that," he
said.
Clement soon followed to say, "I would respectfully suggest that it's a very
funny conception of liberty that forces somebody to purchase an insurance policy
whether they want it or not."
Click here for full coverage of the ObamaCare hearings.
I call it defending the indefensible. What unfolded inside the Supreme Court
on the individual mandate was very clear and direct.
Justice Anthony Kennedy, considered to be the swing vote in this issue,
expressed serious skepticism about the constitutionality of the mandate - the
government requiring citizens to purchase health insurance.
And, his skepticism comes with good reason. The Solicitor General, who had a
difficult day articulating his position supporting the mandate, simple did not
have a viable defense. There is no 'limiting principle' here. In other words, if
the government gives the green light to mandate the purchase of health
insurance, where does it stop?
As I told Sean Hannity on FOX News, the most important development in the
oral arguments about the individual mandate came when Justice Kennedy said the
mandate fundamentally changes the relationship of a citizen with the government.
You can watch the interview
here.
You can never read the tea leaves and predict the outcome of a Supreme Court
case based solely on oral arguments. I've had the privilege to present oral
arguments before the high court 12 times, and participate in 20 cases. What
happens during oral argument certainly plays a key role in the final decision,
but it's always risky to predict an outcome based on that dynamic alone.
What I do know is this. Going into the arguments, those who supported the
individual mandate thought their position would carry the day with ease. When
the arguments were over, it was a different story. With Justice Kennedy voicing
serious concerns about the mandate, it's fair to conclude the mandate may be in
big trouble.
The high court now focuses on the severability issue - whether ObamaCare can
stand even if the mandate is struck as unconstitutional. Our position is the
mandate and the entire health care law need to go
Today, March 28, 2012, is the final day of Supreme Court oral argument on
ObamaCare. Today the Court will consider two issues: (1) whether the individual
mandate (requiring Americans to buy health insurance from private companies for
the rest of their lives or pay annual penalties) is severable from the rest of
ObamaCare and, if not, whether the Court should invalidate the entire law; and
(2) whether the Medicaid expansion is constitutional.
The Court will devote one and one-half hours of oral argument to the
severability issue during its morning session and one hour of oral argument to
the Medicaid issue during its afternoon session.
The individual mandate is the lynchpin of ObamaCare. The federal government
has conceded in court that the individual mandate is the essential component of
ObamaCare's regulation of the health insurance and health care markets. Congress
clearly would not have passed ObamaCare without the individual mandate. Thus,
once the Court determines that the individual mandate is unconstitutional, as it
should, the Court should not sever the mandate from ObamaCare. Absent the
individual mandate, the remaining provisions of ObamaCare cannot function
properly, and the Court should invalidate all of ObamaCare.
The American Center for Law & Justice ("ACLJ") filed an amicus brief on the
severability issue on behalf of itself, 117 Members of the United States
Congress, and more than 103,000 supporters of the ACLJ's efforts to overturn
ObamaCare. You can access that brief
here.
Medicaid is supposed to be a cooperative program between the federal and
State governments to pay medical and health-related expenses for low-income
individuals. Traditionally, State governments have had flexibility on how to
administer their programs, which they themselves manage.
Through ObamaCare, the federal government has reorganized Medicaid to compel
States to add millions of additional people to their Medicaid roles, which will
greatly increase the costs to each State.
Our Constitution embraces the concept of federalism and gives the federal
government only limited, enumerated powers, while the rest of the powers are
retained by the States and the people. Under our Constitution, the federal
government lacks the power to directly require the States to comply with these
new Medicaid requirements.
As such, in ObamaCare the federal government has used its spending power to
indirectly require States to comply with the expansion of Medicaid
This indirect compulsion, however, is indirect in name only because the
States have no choice but to comply. If any State refuses to accept the
reorganization of Medicaid and the associated additional costs to that State,
the federal government can withhold all federal Medicaid funding it
provides to that State, thus putting the entire Medicaid financial burden on
that State.
In 2009, the federal government provided States with more than $250 billion
in Medicaid funding. It is obvious that the threat to withhold all Medicaid
funding will force each State to comply with the new Medicaid requirements.
The Court will consider whether the federal government is permitted to coerce
the States in this way. In the final analysis, the Court should rule that the
Medicaid expansion in ObamaCare is unconstitutional. If it does not, the Court
will be allowing the federal government to use its spending power in a way that
destroys the concept of federalism. The federal government will be able to use
its spending power without limits, and the powers that belong to the States
under our Constitution will be subverted.
The audiotape of the severability oral argument will be available this
afternoon on the Supreme Court's website by 2:00 p.m. eastern time, and the
audiotape of the Medicaid oral argument will be available today by 4:00 p.m.
eastern time. You can access the Court's website
here.