The nation’s top health official signaled Tuesday that states should not try to use the Supreme Court’s ruling on President Obama’s health care law to make it more difficult for low-income people to qualify for Medicaid.
While the Supreme Court upheld most provisions of the health law in its landmark ruling last month, the justices ruled that the federal government could not penalize states that choose not to expand Medicaid by cutting off all funding for existing Medicaid programs.
In a letter to the nation’s governors, Health and Human Services Secretary Kathleen Sebelius warned that “the court’s decision did not affect other provisions of the law” governing the joint federal-state health insurance program for the poor and disabled.
A White House official said that means states are still barred from reducing eligibility for Medicaid.
Some state officials in Maine and several other Republican-led states have seized on the court ruling as effectively invalidating another part of the law, which bars states from tightening Medicaid eligibility. That provision, first enacted in 2009 when the economic stimulus package boosted federal Medicaid dollars, was extended under the 2010 federal health law.
The state officials note the penalty for rolling back eligibility is the same one the high court found “coercive” if states fail to expand Medicaid – the loss of all federal funding for existing Medicaid programs. They say the ruling gives states the option to start cutting Medicaid immediately to save money.
Sebelius does not explicitly address that argument in her letter.
However, as a growing number of Republican governors express reservations about the Medicaid expansion,she said she is “hopeful” state leaders take advantage of the law’s “unusually generous federal resources” to broaden the program to cover everyone with incomes up to 133 percent of the federal poverty level. She noted the federal government will pay the entire cost for three years, from 2014 to 2017, and at least 90 percent after that.
MORE: Administration Warns States Not To Roll Back Medicaid Eligibility – Kaiser Health News.