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Public Health Law Q&A: The Supreme Court’s ACA Medicaid Decision

posted on Tue, May 21 2013 1:11 pm by The Network National Coordinating Center

The Journal of Law, Medicine and Ethics recently released a special issue featuring articles generated by the 2012 Public Health Law Conference.  Jane Perkins, Senior Attorney at the Network’s Southeastern Region and legal director at the National Health Law Program (NHELP), authored “Implications of the Supreme Court’s ACA Medicaid Decision,” exploring the National Federation of Independent Business v. Sebelius (NFIB) case and the subsequent Supreme Court ruling that Congress unduly coerced states when it enacted the Affordable Care Act's Medicaid expansion provision. 

In this Q&A, Jane gives an introduction to her article and how it addresses a critical public health issue.


Q: Why is this topic so critical right now?

A: The Affordable Care Act’s major insurance provisions become effective January 1, 2014. Among these is a Medicaid expansion that, by virtue of the Supreme Court’s decision, is optional with the states. This decision will have implications for state participation moving forward and also for congressional authority to enact laws pursuant to its spending clause authority.

Q: How does your article address this issue and its challenges?

A: The article provides an overview to the Medicaid expansion called for by the ACA , explains the Supreme Court’s National Federal of Independent Business opinion, and describes the potential impact of the case moving forward.

Q: What is the impact of the decision?

A: While leaving most of the ACA intact, the Supreme Court found the Medicaid expansion unduly coercive on the states. The Supreme Court’s remedy was to make this major expansion optional for the states.  

Q: Are there areas of opportunity?

A: States will have the opportunity to expand their Medicaid programs, initially with 100 percent federal funding and, thereafter, with 90 percent federal funding. Medicaid coverage allows individuals to find a regular doctor more easily and to have a resource to cover their preventive and ongoing health care needs.

Read the full article here.

The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state. The views expressed in this post do not represent those of the Robert Wood Johnson Foundation.

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