{mosads}Medicaid is technically a voluntary program. But the states said the healthcare law makes participation all but mandatory because it does not consider alternatives if a state would choose to stop participating in Medicaid.
The healthcare law requires states to enroll in Medicaid everyone with an income at or below 133 percent of the federal poverty level. People with slightly higher incomes will be eligible for subsidies from the federal government to help buy private insurance through a newly created exchange.
The states said in their brief, however, that the law doesn’t spell out alternatives for people whose incomes would make them Medicaid-eligible but who live in a state that elects not to participate in Medicaid because of the expansion.
“While the [Affordable Care Act] purports to leave States’ participation in Medicaid nominally voluntary, multiple aspects of the Act evince Congress’ keen awareness that, in fact, no State will be able to reject its new terms and withdraw from the program,” the brief says.
The healthcare law also says that Medicaid-eligible people who try to buy coverage through an exchange should be automatically enrolled in Medicaid instead. The states say that’s another example that Congress no longer sees the program as voluntary.
The Medicaid claim is slated for oral arguments on the last day of the marathon three-day session before the nine justices in March. A ruling is expected this summer.
— This post was updated at 7 p.m.