Medicaid expansion also at risk in Supreme Court health reform hearings

Opponents target much more than individual mandate

While the constitutionality of the Individual Mandate is the headline issue in this week’s Supreme Court hearings, a lesser understood but fundamental component of the 2010 PPACA health insurance reform laws is also at risk, namely Medicaid expansion.  The PPACA laws mandate an individual obtain coverage or pay a tax penalty (the current MA penalty ranges from $238-$1,212 based on income).  The laws require states to create or expand subsidized and free health insurance plans for low income individuals. The affordable care act also contains provisions wherein the federal government provides additional Medicaid funding to pay for this expansion. In the case before the Supreme Court, the plaintiffs argue that it is coercion to force States to create subsidized health insurance plans and exchanges, or risk losing Medicaid funding from the Feds.

The lower court judge who went the furthest on the broad overhaul, ruling that the whole law should be struck down, nonetheless said he found the challenge to the Medicaid expansion legally unpersuasive. “There is simply no support for the state plaintiffs’ coercion argument in existing case law,” wrote U.S. District Judge Roger Vinson of Pensacola, Fla., in the first decision on the main case now before the Supreme Court.
-Washington Post

PPACA modeled after Massachusetts health reform laws

The Massachusetts model of PPACA has been in place since 2006, so residents here are familiar with the complexities of health insurance reform. However, the fact that 98% of MA residents have health insurance, as well as the lower trending rates in the commercial health insurance market, suggests that health insurance reform is worth the cost.

“I don’t see it as [coercion] at all, I see it as a tremendous opportunity. We know we have poor people who are currently unable to afford private health insurance.”
–Massachusetts health secretary JudyAnn Bigby