The Right View: Maine DHHS correct to challenge Obamacare ruling

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Last week the LePage administration submitted a petition to the U.S. Supreme Court to review the decision of a lower court in the case of Mayhew v. Burwell. Commissioner Mary Mayhew of Maine’s Department of Health and Human Services issued the following statement:

“For the LePage Administration, this case is ultimately about Maine’s right to continue on the path of reprioritizing and reforming MaineCare services to put our most vulnerable elderly and disabled citizens ahead of able-bodied young adults who can provide for themselves.

“We are asking the Supreme Court to review this case because we firmly believe that Maine is on the right path, toward fiscal responsibility and prosperity for all, and the federal government’s path of reckless welfare spending is one that we decline to pursue. This case is of major national significance because it would answer the question of whether a state that expands Medicaid may ever have the flexibility to reverse their decision.”

The 171-page petition states, in part, that the Patient Protection and Affordable Care Act – ACA, or Obamacare – requires any state paying Medicaid to 19- and 20-year-olds as of the ACA’s enactment to continue to do so on the same terms until October 2019, or lose all of its federal Medicaid funding.

When the ACA took effect, Maine was already performing a promise to cover 19- and 20-year-olds through Dec. 31, 2010, in exchange for increased Medicaid reimbursement, as part of the federal stimulus program. In 2012, Maine proposed to cease such coverage. U.S. Secretary of Health and Human Services Sylvia Mathews Burwell ruled that the provision in ACA prohibited the change, and the 1st U.S. Circuit Court of Appeals affirmed the ruling over Maine’s constitutional objections.

Medicaid is a state-federal cooperative program, under which the states administer health-care coverage for the nation’s neediest citizens, with substantial reimbursements from the federal government. Medicaid constitutes by far the largest single line-item in state budgets, and MaineCare (Maine’s Medicaid program) makes up a major portion of Maine’s annual outlays, accounting for just over a third of the state’s total budget in 2013.

In another Supreme Court decision, National Federation of Independent Business v. Sebelius, the justices held that Congress cannot force states to furnish Medicaid to low-income 19- and 20-year-olds. However, a court of appeals had previously held that the ACA can be used to force Maine to furnish such coverage.

Further, in the petition, Mayhew makes the argument that “the court of appeals’ decision impairs Maine’s healthcare and budget priorities to the tune of millions of dollars per year, at least until 2019 and possibly indefinitely. It also injects substantial uncertainty into the ongoing national debate over States’ decisions whether to opt in to the ACA Medicaid Expansion, by suggesting that NFIB notwithstanding, all States may be compelled to cover the 19- and 20-year-old cohort.”

One of the constitutional questions presented for review is whether the clause in the ACA that forces Maine to continue paying Medicaid to 19- and 20-year-olds through 2019 under the threat of losing all of its federal Medicaid dollars exceeds Congress’ power and intrudes on the sovereignty reserved to Maine under the 10th Amendment.

While no doubt vitally important to the funding of MaineCare going forward, in particular the 19- and 20-year-old cohort, and perhaps fascinating stuff to constitutional lawyers, what it means to me is too much federal government intrusion where it doesn’t belong.

The ACA, a government takeover of one of the finest health systems in the world, has essentially squashed a Supreme Court ruling that stated that Congress cannot force states to furnish Medicaid to low-income, yet otherwise able-bodied, 19- and 20-year olds.

The Maine DHHS is correct to ask the Supreme Court to review this case. I commend Commissioner Mayhew for bringing this issue to light and alerting us to the further federal intrusion into states’ rights. Obamacare is a horror that needs to be repealed in its entirety. This is just one shining example of why.

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Julie McDonald-Smith lives in North Yarmouth. She is a registered nurse, former Capitol Hill staffer, and former chairwoman of the Cape Elizabeth Republican Committee. Her column appears every other week.

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