SCOTUS and the ACA: Day 3 of Deliberations Get Underway

Although the subject matter today — the final day of deliberations before the SCOTUS regarding the ACA’s constitutionality — is not as sexy as yesterday’s fiery individual mandate arguments, the overall tone will be just as intense. The expansion of Medicaid to include more than 15 million to its rolls as part of reform takes center stage. The pall cast by yesterday’s perceived negativity toward the reform law’s most contentious provision looms large today, as well.

Although the subject matter today — the final day of deliberations before the SCOTUS regarding the ACA’s constitutionality — is not as sexy as yesterday’s fiery individual mandate arguments, the overall tone will be just as intense. The expansion of Medicaid to include more than 15 million to its rolls as part of reform takes center stage. The pall cast by yesterday’s perceived negativity toward the reform law’s most contentious provision looms large today, as well.

At stake in today’s proceedings is the issue as to whether states have sovereign rights over and above the government’s insistence that they participate in the program’s expansion within reform. Under the ACA, 100 percent of non-elderly, non-disabled, newly qualified beneficiaries whose incomes fall below the approx. 130 percent of the poverty line cutoff will recieve coverage. Opponents of the ACA in its current form argue that this expansion of fed-state matching healthcare funds as a condition of states’ willingness to participate (even though they could opt-out, but would surrender Medicaid funds) is an overreach of legislative powers with respect to spending. SCOTUS will decide if this condition upon particiaption amounts to coercion.

There is also the issue of “severability” — whether the law is able to function if the key mandate provision is struck down. This pesky little matter is what many watchers consider to be the next most important issue as to the justification of the entirety of the extant law — and one about which politicos will use as a wedge no matter what the decision on the feasability of the ACA is come June. In my opinion, another robust day of arguments on the docket … even more compelling than yesterday.