Dear Friends,
Since the Obama administration enacted the landmark Affordable Care Act (ACA) in
March 2010, DREDF has been actively involved in various post-passage aspects of
this new federal health care reform, which have profound ramifications for people with
disabilities. DREDF has addressed some of these ramifications in past eNews editions, and the DREDF
website offers a wealth of additional health access analysis and information.
Most recently, DREDF was part of a broad coalition that filed an amicus (or friend of the court) brief in the U.S. Supreme Court, opposing a constitutional challenge to the
ACA. A diverse coalition of 79 groups joined this particular brief, which addresses
the propriety of the ACA's expansion of Medicaid. The brief argues that the federal
government does have legitimate authority, via the U.S. Constitution's "Spending
Clause," to impose new ACA-related Medicaid requirements on states that accept
federal funding for health care. The Constitution's Spending Clause allows Congress
to offer states money with conditions, thus encouraging states to participate in joint
federal-state efforts to tackle societal challenges, such as education, child welfare,
health care, highway safety, and discrimination, to name a few.
"The Affordable Care Act's expansion of Medicaid eligibility is constitutional," states
Linda D. Kilb, an attorney with the Disability Rights Education & Defense Fund
(DREDF). "If the Supreme Court holds that this expansion of Medicaid eligibility is
unconstitutional, then an array of cooperative federal-state spending programs and
antidiscrimination laws similarly based on Spending Clause authority could also become
subject to constitutional challenge."
The brief was filed on February 17, 2012, in the Florida v. HHS case (U.S. Supreme
Court Docket No. 11-400). It was authored by Law Professor Samuel Bagenstos and
attorneys with the Judge David L. Bazelon Center for Mental Health Law. DREDF was
the leading disability rights law and policy organization participating in the coalition of
education, healthcare, veterans, child welfare, women's sports, and other organizations.
Ira Burnim, legal director of the Bazelon Center for Mental Health Law, emphasizes that
states do have a legal alternative to accepting expanded Medicaid obligations, thus
rebutting one of the central Spending Clause arguments against the landmark law -- that the ACA unlawfully coerces state action. "If the state disagrees with the conditions tied to the federal money, the state can decline the money. The state will have to
answer to its residents about why it declined federal money, but that is democracy -- not
coercion."
"Florida and 25 other states in this case make a very dangerous argument with far-
reaching implications," states Professor Samuel Bagenstos who teaches at the
University of Michigan Law School, offering his perspective on the state's arguments
that Congress exceeded its Spending Clause authority in enacting the ACA. "From
federal foster care and child support enforcement programs to federal support for low-
income schools, children, and participation of girls and young women in school sports
teams -- much more is at stake here than just Medicaid."
Demonstrating the enormous reach of the ACA debate, the brief that DREDF joined
involves just one of the challenges that federal health care reform is facing in the
high court. Other issues include the Minimum Coverage Provision, the Anti-Injunction
Act, Severability, and other aspects of the Medicaid program. DREDF will keep you
posted on developments relating to the ACA in general and the Spending Clause issue
in particular. The U.S. Supreme Court's ruling in the several pending ACA cases is
expected in June 2012.
© 2012
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