10 Polemics from the Supreme Court Decision
9. "What makes that so?"
By page 50 of her 61-page dissent, Justice Ginsburg's exasperation with Roberts shows. In maintaining her argument that PPACA should be allowed to force states to expand their Medicaid programs, she disputes Roberts' contention that what the act is creating a new Medicaid program rather than expanding the existing one.
"The Chief Justice cites three aspects of the expansion," she wrote. "First, he asserts that, in covering those earning no more than 133% of the federal poverty line, the Medicaid expansion, unlike pre-ACA Medicaid, does not 'care for the neediest among us.' What makes that so? Single adults earning no more than $14,856 per year—133% of the current federal poverty level—surely rank among the Nation's poor."
10. "Gun to the head"
Chief Justice Roberts said that is what PPACA would in essence be aiming at states under the threat that if they refused to expand Medicaid to people who earn up to 133% of the federal poverty level, they would lose all federal Medicaid funding. "In this case, the financial 'inducement' Congress has chosen is much more than 'relatively mild encouragement'—it is a gun to the head," Roberts wrote.
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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