Politico is reporting that members of the U.S. Supreme Court, who heard arguments yesterday about the part of the health care law that expands Medicaid, were skeptical of the claims made by the states challenging the mandate.

The 26 states, led by Florida, challenging the Affordable Care Act in the Supreme Court this week argue that the law would impose an enormous financially burden on them. But, Supreme Court justices, including the more conservative members, expressed skepticism.

According to Politico:

But [Chief Justice John Roberts’] questions suggested that not all of the conservative justices will be an easy sell for the states’ case that Congress overstepped its powers by requiring all states to expand their Medicaid programs, starting in 2014, as a condition for receiving federal Medicaid funds.

The states have been accepting federal Medicaid money with strings attached for years, Roberts said, so “they shouldn’t be surprised that the federal government has decided to pull them.”

The 26 states want the Supreme Court to say that the law’s Medicaid expansion is “coercive” because the federal government is holding huge amounts of federal funding over the states’ heads to get them to act.

The court has said that at some point, the threat of losing federal money becomes unconstitutionally coercive, but has not identified where that line is.

Justice Elena Kagan pounded Paul Clement, the attorney for the states, with questions about whether the Medicaid expansion is really an unreasonable demand for the states — especially when the federal government will pick up all of the costs in the early years and most of the costs in the later years.

“Why is a big gift from the federal government a matter of coercion?” Kagan asked. “It’s just a boatload of federal money for you to take and spend on poor people’s health care.”

Gov. Rick Scott has repeatedly claimed the costs of Medicaid (which is largely subsidized by the federal government) is one of the big culprits for the state’s continued budget problems. Just this week Scott said on Fox and Friends that  the law would impact Florida greatly because it would add a “cost to [Florida’s] Medicaid program” that he says the state “cannot afford.”

Scott’s claim that the law requires states to “dramatically expand Medicaid” has been a common argument made by state officials opposing the law. But Florida public policy experts say that Scott’s, and others, arguments about the Medicaid expansion have been “vastly inflated [and] lacking in merit.”

The Florida Center on Fiscal and Economic Policy, a progressive-leaning public policy group, released a report last week that claimed “the extent to which state projections of the cost of Medicaid expansion under the Affordable Care Act have been hyper-inflated is troubling, and they appear to have been specifically crafted to support a political position rather than provide a backdrop for planning purposes.”

Not all defenses of the health care law have been as strong as yesteray’s Medicaid expansion arguments. Tuesday, the Obama administration’s defense of the hotly contested individual mandate did not go as smoothly, signaling that there may be some trouble for parts of the law.

You May Also Like

Family planning requirements may complicate federal approval of Florida Medicaid waiver

According to The News Service of Florida, Florida health officials have “less than three months to develop a detailed Medicaid-overhaul plan to sell to the Obama administration. But whether or not the federal government will give Florida a go-ahead with its proposed overhaul is unclear, due to certain provisions that conflict with basic federal laws.” Among these conflicts is a provision that allows Medicaid providers to opt-out of providing family planning services on “moral or religious grounds.”