The Medicaid Conflict: Federal and State
POL201: American National Government
August 12, 2013
Medicaid: Federal and State
Currently there is a heated debate that has been brewing between the federal government and the states over the implementation of the Medicaid expansion that is set to begin in 2014. The recent ruling of the Supreme Court gave the states freedom to opt out of implementing the expansion. The Medicaid expansion stands as an example of why the Constitutional Framework of Federalism is vital in defining boundaries that often seem blurred, between the federal government and the states. The Medicaid expansion is attached to the Patient Protection and Affordable Care Act that is set to take effect January 1, 2014. It is aimed at including additional uninsured people into the Medicaid program, particularly adults ages 19-65. On June 28, 2012 the Supreme Court ruled the Medicaid expansion was unconstitutional. According to the 10th Amendment of the United States Constitution, “…powers not granted to the United States were reserved to the States or to the people.” (Cornell University Law School, n.d.). The constitutional framework of federalism limits the power in which the federal government has over the states. The government is only allowed to give extra funding as an incentive to the participating states, but not to punish and remove funding from those that do not. It would also not be permitted under the Commerce Clause that states, “national government can regulate various activities so long as they bear on interstate commerce.” (Levin-Waldman, 2012). The Supreme Court deemed it was unconstitutional for the federal government to withhold Medicaid funding for the states that did not elect to participate thus creating an unfair financial strain on the states. As a result of the ruling, the States now have the option to reject participation in the Medicaid expansion without fear of losing the funding they are currently receiving....
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