First Florida, then Texas, and now Kansas and Tennessee have been told by the Obama administration that unless they expand Medicaid under the rules laid out in ObamaCare the federal government will withhold payments from local hospitals.
Florida’s Republican Governor Rick Scott is so angry at the move he’s promised to sue the Obama administration for violating a 2012 U.S. Supreme Court ruling prohibiting the feds from conditioning Medicaid funding on ObamaCare expansion.
Yet this is precisely what the Centers for Medicare and Medicaid Services (CMS) is doing. According to Kaiser Health News, CMS “confirmed Tuesday that it gave officials in [Kansas and Tennessee] the same message that had been delivered to Texas and Florida about the risk to funding for so-called ‘uncompensated care pools’ – Medicaid money that helps pay the cost of care for the uninsured.”
“Medicaid expansion would reduce uncompensated care in the state, and therefore have an impact on the [Low-Income Pool], which is why the state’s expansion status is an important consideration in our approach regarding extending the LIP beyond June,” a CMS official warned.
The reason states have resisted expanding Medicaid under ObamaCare is that it transforms a program currently helping discrete populations – e.g. pregnant women, the disabled, elderly, blind, and children from needy families – into a universal, taxpayer-funded health insurance program for every person earning less than 133 percent of the federal poverty level. That change translates into large amounts of new spending that will eventually lead to increased state taxes.
By making a state’s refusal to expand Medicaid a factor in deciding whether Medicaid dollars will continue to flow, the Obama administration is directly flouting a prohibition handed down by a 7-2 Supreme Court majority (liberal Justices Kagan and Breyer sided with their five more conservative colleagues). If the Supreme Court wants to ensure that its rulings will be taken seriously, it should fast-track Florida’s lawsuit and let the Obama administration know it must follow the law.