Rob Natelson: On the Medicaid Expansion—Yes, Montana Should Say No

When the Supreme Court’s Obamacare case was pending, I noticed that while there was a lot of attention given to the individual insurance mandate, there was little discussion of the Medicaid expansion.

The Medicaid extension was the part of the law that sought to force states into signing up for an expensive new program by threatening to cut off all Medicaid funds if they did not.

Whether the individual mandate was constitutional was an arguable question under the Supreme Court’s modern jurisprudence.  (As you probably know, the court’s modern law on federal regulation and spending is largely disconnected from the Constitution’s actual meaning.)

But the Medicaid mandate was different. However, I looked at it—under modern law or the Constitution’s actual meaning—that mandate seemed flagrantly unconstitutional to me. But almost no one was addressing it.

As a result, I authored one of the very few Supreme Court briefs to address the issue in detail. The brief was edited and filed by Dave Kopel at the Independence Institute, where I am also a senior fellow.

Against all popular expectations, we won: By a 7-2 margin, the Supreme Court struck down the coercive portion off the Medicaid expansion. This left the states free to make their own decisions.

A recent MPI post explains why Montana should not sign up for the budget-busting, dependency-creating Medicaid expansion. As if any additional reasons were necessary, health care expert Linda Gorman adds this compelling argument. It’s written for Colorado, but applies to Montana as well.

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