Whither the Medicaid Expansion?

Like all of you, I am still waiting to get a copy of the actual opinion.  But from the reporting of our friends at SCOTUSBlog, it sure sounds like the Medicaid expansion just became essentially voluntary for the states because the federal government can no longer use the “stick” of cutting off pre-existing funds to persuade the states to go along with the Medicaid expansion.  If borne out by the opinion, that is pretty significant.

Update (11:55 am).  Shore ’nuff.  From page 57 of the Chief Justice’s opinion (which is borne out by the other opinions): “As a practical matter, th[e holding of the Court] means States may now choose to reject the [Medicaid] expanasion; that is the whole point.”

Seven Justices of the Supreme Court, including two Democratic appointeees  (Justices Breyer and Kagan) considered the Medicaid expansion impermissibly coercive under the Spending Clause.  They are the first Court to hold this law invalid under that line of analysis, and if memory serves, the first court in history to invalidate a law as impermissibly coercive.

Note also the joint dissent echoing a couple themes of Paul Clement’s briefing and argument, both of which I thought were very savvy: accountability (p.34) and the idea that if this law isn’t unduly coercive, there is no point to saying there is such a requirement in the law (p.38).


Apologies for any typos that appeared in earlier postings, but it’s hard to convey exactly how badly the software was malfunctioning.