A critical method that healthcare "reform" will use to decrease the number of the uninsured (without increasing access to care) is to force States to expand Medicaid eligibility. The U.S. Supreme Court has specifically agreed to consider arguments about the constitutionality of the Medicaid Expansion Provisions (MXPs) in the case against the Affordable Care Act (ACA or “ObamaCare”) brought by Florida and 25 other States..
The government argues that MXPs aren’t really coercive but are simply a condition for continued receipt of Medicaid funding. States could simply withdraw from Medicaid and lose the entirety of their federal funding for indigent medical care—while their citizens continue to pay federal taxes to fund Medicaid in other States.
The Association of American Physicians and Surgeons (AAPS) argues in an amicus brief filed January 17 that such a Hobson’s choice is no choice at all. “Regardless of the choice each State makes, that State’s spending will increase.” The State’s taxpayers will be burdened to pay for the increase without an affirmative decision of its legislature and governor, but by federal fiat. Thus, the MXPs are “an assault on the sovereignty of the States and the rights of their citizens.”
Many States are in a precarious fiscal situation, and according to the U.S. Government Accountability Office (GAO), “the primary driver of the fiscal pressure confronting the state and local sector is the continued growth in health-related costs.”
“Our nation cannot plunder the treasuries of its political subdivisions…without putting the existence of the States in jeopardy,” writes AAPS.
The onerous burdens that the MXPs lay on the States continue into the indefinite future. In effect, the MXPs place federal and State spending on “auto pilot” beyond the end of the term of this Congress, thus withholding legislative power from future Congresses and veto power from future Presidents.
Additionally, directing States to spend money in particular ways is not among the Constitutionally enumerated powers of Congress.
If the MXPs are unconstitutional, then the ACA must be declared unconstitutional in its entirety, AAPS argues, citing AAPS’s separate amicus brief filed on Jan 6 on the issue of severability and the individual mandate. “Severance, in the absence of a severability clause, wreaks havoc on the Constitution’s system of checks and balances and ignores the Separation of Powers doctrine," states the AAPS brief.
On Friday January, 6, 2011 AAPS along with individual physicians submitted a third brief in as many months advising the Supreme Court that the individual mandate in the Patient Protection and Affordable Care Act is unconstitutional and that the entire law must be thrown out.
The Citizens' Council for Health Freedom also joined AAPS in this brief. The CCHF exists to support patient and doctor freedom, medical innovation and the right of citizens to a confidential patient-doctor relationship. Learn more about CCHF at http://www.cchfreedom.org.
The amicus brief reads in part:
"ACA undermines, in fundamental and dangerous ways, the practice of medicine, and harms patients. Amici argue that severance of the individual mandate of Section 1501 without invalidating all of ACA will improperly burden the practice of medicine as well as the dockets of this Court, the Courts of Appeals and the District Courts, for many years to come."
Immediately following the signing of PPACA in March 2010, AAPS filed suit in United States District Court, http://www.aapsonline.org/hhslawsuit, to stop the law and has filed numerous amicus briefs to support the other cases brought against ObamaCare, to inform the courts that "ACA undermines, in fundamental and dangerous ways, the practice of medicine, and harms patients."