Labor Groups Say States’ Challenge of Medicaid Expansion is Aimed at Radically Limiting Congressional Spending Power

by Jeremy Leaming

The slew of states challenging the constitutionality of the Affordable Care Act’s expansion of Medicaid to cover more of the nation’s poorest, has failed to articulate why the U.S. Supreme Court should invalidate Congress’s expansion of the popular program, SEIU and other labor groups assert in a recently filed friend-of-the-court brief.

Plenty of attention has been given to the landmark health care reform law’s minimum coverage provision. That provision requires Americans, who can afford to do so, to purchase a minimum amount of health care insurance starting in 2014 or pay a penalty on their income tax returns. Indeed this recent panel sponsored by SCOTUSblog and BloombergLaw focused almost entirely on the legal challenge to the minimum coverage provision, which in all fairness is the law’s integral provision.

But the amicus brief in Florida v. U.S. Department of Health and Human Services filed by SEIU and Change to Win, a federation of four labor unions, argues that if the challengers’ argument were adopted by the court it would greatly limit the ability of the Congress to tax and spend for the general welfare. (SEIU is the country’s largest healthcare union, and the unions that make up Change to Win represent more than 5 million workers.)

The labor groups assert that the states challenging the expansion of Medicaid are not questioning the constitutionality of Medicaid, but are trying to scuttle lawmakers’ expansion of the popular program. The challengers, the labor groups argue, claim that they are being unconstitutionally coerced into offering the expanded Medicaid program (primarily because Medicaid is so popular that the states could not opt-out of offering it), but fail “to identify some constitutionally relevant and judicially manageable distinction between the pre-existing federal spending program and the expanded program they challenge.”

The states’ challenge to the expansion of Medicaid, which is also important to the law’s goal of providing more health care insurance to the tens of millions of uninsured, is aimed directly at “Congress’ power to spend federal money on those programs (and only those programs) that Congress deem worthy of support,” the labor groups’ brief states.

None of the lower courts ruled that Congress ran a foul its constitutional authority by expanding Medicaid, nonetheless, the high court granted oral argument over the challenge.

So what are the states’ relying on when arguing that the Medicaid expansion is unconstitutional? Not much, according to SEIU and Change to Win.

Specifically the states point to nonbinding language from high court cases that merely suggest Congress’ power to tax and spend for the general welfare could be limited if it proved unduly coercive.

Indeed as the groups’ brief notes, that’s likely all the states could rely upon since no “federal court has ever struck down a Spending Clause statute on the ground that it impermissibly ‘coerces’ the States.” One of the cases the states relies upon, Steward Machine Co. v. Davis, upheld a tax “ten times greater in magnitude on employers in States that chose not to implement an unemployment insurance program meeting federal specifications.”

What the states are hoping for is a conservative activist majority on the Supreme Court; one that will adopt an argument that would seriously restrict the ability of the federal government to tax and spend for the general welfare.

“The logic of the Petitioners’ [the states’] argument also would lead to the truly perverse result that the larger and more important the social problem Congress seeks to address, the more popular and effective Congress’ design proves to be, and the more that States find that Congress’ program benefits their citizens, the more constitutionally suspect the program would become. This cannot be the law. Congress has every right (indeed, a solemn responsibility) to spend federal moneys to ameliorate serious social problems. The extent to which Congress succeeds in addressing such problems of national concern simply cannot be a factor leading to the invalidation of federal legislation.”