Implications of the Supreme Court Ruling on Medicaid

Jordan Apfeld, BA; Andrew Han; Tyler Stern; Hassan Mir, MD; William T. Obremskey, MD, MPH; A. Alex Jahangir, MD; and Manish K. Sethi, MD

The recent decision by the Supreme Court of the United States of America (SCOTUS) about the Patient Protection and Affordable Care Act (PPACA) included a ruling on the use of Medicaid to increase the number of Americans with healthcare coverage. PPACA attempted to mandate an expanded Medicaid program by requiring states to cover individuals younger than age 65 with incomes at or below 133 percent of the federal poverty level. States that did not comply would lose all federal Medicaid funds.

The Court ruled that only new funds available to the states under the expansion could be withheld if states did not comply with the expanded program. In his opinion, Chief Justice Roberts ruled that imposing stipulations on all Medicaid funding “crossed the line from encouragement to coercion.” Thus, the ruling made it possible for states to opt out of an expanded Medicaid program. And recently, the Centers for Medicare & Medicaid Services (CMS) announced that states that expand their Medicaid programs may choose to drop the expansion later.

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