A coalition of more than sixty Christian, Muslim, Jewish, Buddhist and interfaith groups have called on the U.S. Supreme Court to protect Medicaid expansions inside of the Patient Protection and Affordable Care Act (PPACA), saying that the provisions are both constitutional and "morally right."
In an amicus brief submitted earlier this month, the coalition said that while they have different perspectives on many issues, they all agree that, "it is the calling of government to bring justice and protection to the poor and sick" and for this reason have "long supported Medicaid," including the PPACA's provision that coverage be expanded to people with incomes below 133 percent of the poverty level.
"The ACA bolsters Medicaid with nation-wide standards of care and eligibility, available at last to all low-income Americans," the coalition's 45-page brief reads. "Comparable to the lawful establishment and administration of our nation's interstate highways, power grid, water supply, and communications systems, the ACA's Medicaid improvements and expansions help strengthen federal and state partnerships to create a seamless health care safety net that goes beyond the vagaries of mercy to the reliability of justice and fairness."
In mid-January a group of 26 states filed a brief with the Supreme Court arguing that while states can nominally opt out of the Medicaid program, the PPACA unlawfully coerces them into accepting the Medicaid expansion under threat of losing all federal health-care funding.
The interfaith group disagreed in their brief saying that the current Medicaid expansion is no different from previous expansions Congress has made over the past four decades and that states do not have an "automatic right" to federal dollars if they disagree with a program's measures.
"It does not follow…that the Petitioners can legitimately claim legal coercion here where what they are really claiming is nothing more than a right to existing Medicaid funding levels for partial participation in the program or a right to a tax credit for opting out of the program," the groups write.
The coalition continues by saying that the most important decision the states need to make is whether they will accept the "moral imperative" of caring for the poor that Medicaid helps them to accomplish.
"Nothing in the ACA requires states to participate in this expansion. The states resist simply withdrawing from Medicaid, however, because state legislators understand that they are subject to a greater law than the ACA-a moral imperative to care for the poor and the sick," the brief says.
"The ACA broadens our nation's understanding of the moral imperative that has long grounded [Social Security Act] programs," it continues. "It brings us closer to the moral vision of our faith communities-a vision that recognizes the needs of all of those who cannot afford health care, not just those who fit into particular categorical pigeon holes."
The PPACA's Medicaid provision is one of four issues in the health care law that will be reviewed by the Supreme Court during hearings later this month and is considered the most difficult measure for opponents to overturn.
The more favorable provision for the states to challenge is the PPACA's mandate for all citizens to purchase health care, which has already been ruled unconstitutional on three separate occasions.
The Supreme Court will also need to review whether the mandate can be severed from the rest of the PPACA. If the court holds that the mandate is unconstitutional and says it cannot be severed from the rest of the law, the entire law would be thrown out.
Last August, the 11th Circuit Court of Appeals agreed with two previous rulings that the mandate was unconstitutional but said that the provision could be separated from the rest of the law.
The Supreme Court will hear new arguments on the issue from Monday, March 26 to Wednesday, March 28.