Supreme Court split over scrapping entire health care law

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Later Wednesday, the justices grappled with the Medicare expansion provisions, which 26 states have challenged.

They argue that it is coercive for the federal government to say billions of dollars in new Medicaid funding are available only if states add millions of new beneficiaries. The administration says states are free to reject the expansion, but the states say that’s virtually impossible because so much federal money is at stake.

Justice Scalia seemed to agree with the states, comparing the choice to being asked “for your money or your life” — an offer no one can refuse.

But Democrat-appointed justices appeared deeply skeptical of the claim that states are being coerced into accepting federal money just because there’s a lot of it.

“Why is a big gift from the federal government a matter of coercion?” Justice Elena Kagan asked Mr. Clement. “It doesn’t sound coercive to me, I have to tell ya.”

Mr. Clement tried to draw a distinction between the Medicaid expansion under the health care law and times in the past when the government has expanded the program, saying this expansion is more “breathtaking” in its scope than ever before.

But Solicitor General Donald B. Verrilli Jr., arguing for the administration, said that under that reasoning, the Medicaid program could have been deemed unconstitutional a long time ago.

Justice Kennedy, a frequent swing vote on the court, agreed that a line needs to be drawn somewhere.

“A point of being ‘too big’ could be when accountability is lost,” Justice Kennedy said, also expressing concern that the states will have to take on more administration expenses if they accept the extra Medicaid dollars.

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