Justice Ginsburg | PPACA | Obamacare | Shared Responsibility Payment

Discussion in 'Judicial Interpretation' started by Dante, Jan 22, 2015.

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    THE CHIEF JUSTICE finds the Medicaid expansion vulnerable because it took participating States by surprise. Ante, at 54. “A State could hardly anticipate that Congress” would endeavor to “transform [the Medicaid program] so dramatically,” he states. Ante, at 54–55. For the notion that States must be able to foresee, when they signup, alterations Congress might make later on, THE CHIEF
    JUSTICE cites only one case: Pennhurst State School and Hospital v. Halderman, 451 U. S. 1.

    In Pennhurst, residents of a state-run, federally funded institution for the mentally disabled complained of abusive treatment and inhumane conditions in alleged violation of the Developmentally Disabled Assistance and Bill of Rights Act. 451 U. S., at 5–6. We held that the State was not answerable in damages for violating conditions it did not “voluntarily and knowingly accep[t].” Id., at 17, 27. Inspecting the statutory language and legislative history, we found that the Act did not “unambiguously” impose the requirement on which the plaintiffs relied: that they receive appropriate treatment in the least restrictive environment. Id., at 17–18. Satisfied that Congress had not clearly conditioned the States’ receipt of federal funds on the States’ provision of such treatment, we declined to read such a requirement into the Act. Congress’ spending power, we concluded, “does not include surprising participating States with post acceptance or ‘retroactive’ conditions.” Id., at 24–25.

    Pennhurst thus instructs that “if Congress intends to impose a condition on the grant of federal moneys, it must do so unambiguously.” Ante, at 53 (quoting Pennhurst, 451 U. S., at 17). That requirement is met in this case.Section 2001 does not take effect until 2014. The ACA makes perfectly clear what will be required of States that accept Medicaid funding after that date: They must extend eligibility to adults with incomes no more than 133% of the federal poverty line. See 42 U. S. C. §1396a(a)(10)(A) (i)(VIII) (2006 ed. and Supp. IV).

    THE CHIEF JUSTICE appears to find in Pennhurst a requirement that, when spending legislation is first passed, or when States first enlist in the federal program, Congress must provide clear notice of conditions it might later impose. If I understand his point correctly, it was incumbent on Congress, in 1965, to warn the States clearly of the size and shape potential changes to Medicaid might take. And absent such notice, sizable changes could not be made mandatory. Our decisions do not support such a requirement. [21]

    [21] THE CHIEF JUSTICE observes that “Spending Clause legislations much in the nature of a contract.” Ante, at 46 (internal quotation marks omitted). See also post, at 33 (joint opinion of SCALIA, KENNEDY, THOMAS, and ALITO, JJ.) (same). But the Court previously has recognized that “unlike normal contractual undertakings, federal grant programs originate in and remain governed by statutory provisions expressing the judgment of Congress concerning desirable public policy.” Bennett v. Kentucky Dept. of Ed., 470 U. S. 656, 669 (1985).
    In Bennett v. New Jersey, 470 U. S. 632 (1985), the Secretary of Education sought to recoup Title I funds [22] based on the State’s noncompliance, from 1970 to 1972, with a 1978 amendment to Title I. Relying on Pennhurst, we rejected the Secretary’s attempt to recover funds based on the States’ alleged violation of a rule that did not exist when the State accepted and spent the funds. See 470
    U. S., at 640 (“New Jersey[,] when it applied for and received Title I funds for the years 1970–1972[,] had no basis to believe that the propriety of the expenditures would be judged by any standards other than the ones in effect at the time.” (citing Pennhurst, 451 U. S., at 17, 24– 25; emphasis added)).

    [22] Title I of the Elementary and Secondary Education Act of 1965 provided federal grants to finance supplemental educational programs in school districts with high concentrations of children from low-income families. See Bennett v. New Jersey, 470 U. S. 632, 634–635 (1985) (citing Pub. L. No. 89–10, 79 Stat. 27).
    When amendment of an existing grant program has no such retroactive effect, however, we have upheld Congress’ instruction. In Bennett v. Kentucky Dept. of Ed., 470 U. S. 656 (1985), the Secretary sued to recapture Title I funds based on the Commonwealth’s 1974 violation of a spending condition Congress added to Title I in 1970. Rejecting Kentucky’s argument pinned to Pennhurst, we held that the Commonwealth suffered no surprise after accepting the federal funds. Kentucky was therefore obliged to re- turn the money. 470 U. S., at 665–666, 673–674. The conditions imposed were to be assessed as of 1974, in light of “the legal requirements in place when the grants were made,” id., at 670, not as of 1965, when Title I was originally enacted.

    As these decisions show, Pennhurst’s rule demands that conditions on federal funds be unambiguously clear at the time a State receives and uses the money—not at the time,perhaps years earlier, when Congress passed the law establishing the program. See also Dole, 483 U. S., at 208 (finding Pennhurst satisfied based on the clarity of the Federal Aid Highway Act as amended in 1984, without looking back to 1956, the year of the Act’s adoption).

    In any event, from the start, the Medicaid Act put States on notice that the program could be changed: “The right to alter, amend, or repeal any provision of [Medicaid],” the statute has read since 1965, “is hereby reserved to the Congress.” 42 U. S. C. §1304. The “effect of these few simple words” has long been settled. See National Railroad Passenger Corporation v. Atchison, T. & S. F. R. Co., 470 U. S. 451, 467–468, n. 22 (1985) (citing Sinking Fund Cases, 99 U. S. 700, 720 (1879)). By reserving the right to “alter, amend, [or] repeal” a spending program,Congress “has given special notice of its intention to retain . . . full and complete power to make such alterations and amendments . . . as come within the just scope of legislative power.” Id., at 720.

    Our decision in Bowen v. Public Agencies Opposed to Social Security Entrapment, 477 U. S. 41, 51–52 (1986), is guiding here. As enacted in 1935, the Social Security Act did not cover state employees. Id., at 44. In response to pressure from States that wanted coverage for their employees, Congress, in 1950, amended the Act to allow States to opt into the program. Id., at 45. The statutory provision giving States this option expressly permitted them to withdraw from the program. Ibid.

    Beginning in the late 1970’s, States increasingly exercised the option to withdraw. Id., at 46. Concerned that withdrawals were threatening the integrity of Social Security, Congress repealed the termination provision.Congress thereby changed Social Security from a program voluntary for the States to one from which they could not escape. Id., at 48. California objected, arguing that the change impermissibly deprived it of a right to withdraw from Social Security. Id., at 49–50. We unanimously rejected California’s argument. Id., at 51–53. By including in the Act “a clause expressly reserving to it ‘[t]he right to alter, amend, or repeal any provision’ of the Act,” we held, Congress put States on notice that the Act “created no contractual rights.” Id., at 51–52. The States therefore had no law-based ground on which to complain about the amendment, despite the significant character of the change.

    THE CHIEF JUSTICE nevertheless would rewrite §1304to countenance only the “right to alter somewhat,” or “amend, but not too much.” Congress, however, did not so qualify §1304. Indeed, Congress retained discretion to “repeal” Medicaid, wiping it out entirely. Cf. Delta Air Lines, Inc. v. August, 450 U. S. 346, 368 (1981) (Rehnquist,J., dissenting) (invoking “the common-sense maxim that the greater includes the lesser”). As Bowen indicates, no State could reasonably have read §1304 as reserving to Congress authority to make adjustments only if modestly sized.

    In fact, no State proceeded on that understanding. In compliance with Medicaid regulations, each State expressly undertook to abide by future Medicaid changes. See 42 CFR §430.12(c)(1) (2011) (“The [state Medicaid] plan must provide that it will be amended whenever necessary to reflect . . . [c]hanges in Federal law, regulations, policy interpretations, or court decisions.”). Whenever a State notifies the Federal Government of a change in its own Medicaid program, the State certifies both that it knows the federally set terms of participation may change, and that it will abide by those changes as a condition of continued participation. See, e.g., Florida Agency for Health Care Admin., State Plan Under Title XIX of the Social Security Act Medical Assistance Program §7.1, p. 86 (Oct.6, 1992).

    THE CHIEF JUSTICE insists that the most recent expansion, in contrast to its predecessors, “accomplishes a shift in kind, not merely degree.” Ante, at 53. But why was Medicaid altered only in degree, not in kind, when Congress required States to cover millions of children and pregnant women? See supra, at 41–42. Congress did not “merely alte[r] and expan[d] the boundaries of ” the Aid to Families with Dependent Children program. But see ante, at 53–55. Rather, Congress required participating States to provide coverage tied to the federal poverty level (as it later did in the ACA), rather than to the AFDC program. See Brief for National Health Law Program et al. as Amici Curiae 16–18. In short, given §1304, this Court’s construction of §1304’s language in Bowen, and the enlargement of Medicaid in the years since 1965, [23] a State would be hard put to complain that it lacked fair notice when,in 2010, Congress altered Medicaid to embrace a larger portion of the Nation’s poor.
    [/S]
    [23] Note, in this regard, the extension of Social Security, which began in 1935 as an old-age pension program, then expanded to include survivor benefits in 1939 and disability benefits in 1956. See Social Security Act, ch. 531, 49 Stat. 622–625; Social Security Act Amendments of 1939, 53 Stat. 1364–1365; Social Security Amendments of1956, ch. 836, §103, 70 Stat. 815–816.
     
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    THE CHIEF JUSTICE ultimately asks whether “the financial inducement offered by Congress . . . pass[ed] the point at which pressure turns into compulsion.” Ante, at 50 (internal quotation marks omitted). The financial inducement Congress employed here, he concludes, crosses that threshold: The threatened withholding of “existing Medicaid funds” is “a gun to the head” that forces States to acquiesce. Ante, at 50–51 (citing 42 U. S. C. §1396c). [24]

    THE CHIEF JUSTICE sees no need to “fix the outermost line,” Steward Machine, 301 U. S., at 591, “where persuasion gives way to coercion,” ante, at 55. Neither do the joint dissenters. See post, at 36, 38. [25] Notably, the decision on which they rely, Steward Machine, found the statute at issue inside the line, “wherever the line may be.” 301 U. S., at 591.

    When future Spending Clause challenges arrive, as they likely will in the wake of today’s decision, how will litigants and judges assess whether “a State has a legitimate choice whether to accept the federal conditions in exchange for federal funds”?
    Ante, at 48. Are courts to measure the number of dollars the Federal Government might withhold for noncompliance? The portion of the State’s budget at stake? And which State’s—or States’— budget is determinative: the lead plaintiff, all challenging States (26 in this case, many with quite different fiscal situations), or some national median? Does it matter that Florida, unlike most States, imposes no state income tax,and therefore might be able to replace foregone federal funds with new state revenue? [26] Or that the coercion state officials in fact fear is punishment at the ballot box for turning down a politically popular federal grant?

    The coercion inquiry, therefore, appears to involve political judgments that defy judicial calculation. See Baker v.Carr, 369 U. S. 186, 217 (1962). Even commentators sympathetic to robust enforcement of Dole’s limitations, see supra, at 46, have concluded that conceptions of “impermissible coercion” premised on States’ perceived inability to decline federal funds “are just too amorphous to be judicially administrable.” Baker & Berman, Getting off the Dole, 78 Ind. L. J. 459, 521, 522, n. 307 (2003) (citing, e.g., Scalia, The Rule of Law as a Law of Rules, 56 U. Chi. L. Rev. 1175 (1989)).

    At bottom, my colleagues’ position is that the States’ reliance on federal funds limits Congress’ authority to alter its spending programs. This gets things backwards: Congress, not the States, is tasked with spending federal money in service of the general welfare. And each successive Congress is empowered to appropriate funds as it sees fit. When the 110th Congress reached a conclusion about Medicaid funds that differed from its predecessors’ view,it abridged no State’s right to “existing,” or “pre-existing,”funds. But see ante, at 51–52; post, at 47–48 (joint opinion of SCALIA, KENNEDY, THOMAS, and ALITO, JJ.).

    For, in fact, there are no such funds. There is only money States anticipate receiving from future Congresses.


    [24] The joint dissenters, for their part, would make this the entire inquiry. “f States really have no choice other than to accept the package,” they assert, “the offer is coercive.” Post, at 35. THE CHIEF JUSTICE recognizes Congress’ authority to construct a single federal program and “condition the receipt of funds on the States’ complying with restrictions on the use of those funds.” Ante, at 50. For the joint dissenters, however, all that matters, it appears, is whether States can resist the temptation of a given federal grant. Post, at 35. On this logic, any federal spending program, sufficiently large and well-funded, would be unconstitutional. The joint dissenters point to smaller programs States might have the will to refuse. See post, at 40–41 (elementary and secondary education). But how is a court to judge whether“only 6.6% of all state expenditures,” post, at 41, is an amount States could or would do without?

    Speculations of this genre are characteristic of the joint dissent. See, e.g., post, at 35 (“it may be state officials who will bear the brunt of public disapproval” for joint federal-state endeavors); ibid., (“federal officials . . . may remain insulated from the electoral ramifications of their decision”); post, at 37 (“a heavy federal tax . . . levied to support a federal program that offers large grants to the States . . . may, as a practical matter, [leave States] unable to refuse to participate”); ibid. (withdrawal from a federal program “would likely force the State to impose a huge tax increase”); post, at 46 (state share of ACA expansion costs “may increase in the future”) (all emphasis added; some internal quotation marks omitted). The joint dissenters are long on conjecture and short on real-world examples.

    [25] The joint dissenters also rely heavily on Congress’ perceived intent to coerce the States. Post, at 42–46; see, e.g., post, at 42 (“In crafting the ACA, Congress clearly expressed its informed view that no State could possibly refuse the offer that the ACA extends.”). We should not lightly ascribe to Congress an intent to violate the Constitution (at least as my colleagues read it). This is particularly true when the ACA could just as well be comprehended as demonstrating Congress’ mere expectation, in light of the uniformity of past participation and the generosity of the federal contribution, that States would not withdraw. Cf. South Dakota v. Dole, 483 U. S. 203, 211 (1987) (“We cannot conclude . . . that a conditional grant of federal money . . . is unconstitutional simply by reason of its success in achieving the congressional objective.”).


    [26] Federal taxation of a State’s citizens, according to the joint dissenters, may diminish a State’s ability to raise new revenue. This, in turn, could limit a State’s capacity to replace a federal program with an“equivalent” state-funded analog. Post, at 40. But it cannot be true that “the amount of the federal taxes extracted from the taxpayers of a State to pay for the program in question is relevant in determining whether there is impermissible coercion.” Post, at 37. When the United States Government taxes United States citizens, it taxes them “in their individual capacities” as “the people of America”—not as residents of a particular State. See U. S. Term Limits, Inc. v. Thornton, 514 U. S. 779, 839 (1995) (KENNEDY, J., concurring). That is because the “Framers split the atom of sovereignty[,] . . . establishing two orders of government”—“one state and one federal”—“each with its own direct relationship” to the people. Id., at 838.

    A State therefore has no claim on the money its residents pay in federal taxes, and federal “spending programs need not help people in all states in the same measure.” See Brief for David Satcher et al. as Amici Curiae 19. In 2004, for example, New Jersey received 55 cents in federal spending for every dollar its residents paid to the Federal Government in taxes, while Mississippi received $1.77 per tax dollar paid. C. Dubay, Tax Foundation, Federal Tax Burdens and Expenditures by State: Which States Gain Most from Federal Fiscal Operations? 2 (Mar. 2006). Thus no constitutional problem was created when Arizona declined for 16 years to participate in Medicaid, even though its residents’ tax dollars financed Medicaid programs in every other State.
     
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    Congress has delegated to the Secretary of Health and Human Services the authority to withhold, in whole or in part, federal Medicaid funds from States that fail to comply with the Medicaid Act as originally composed and as subsequently amended. 42 U. S. C. §1396c. [27]

    THE CHIEF JUSTICE, however, holds that the Constitution precludes the Secretary from withholding “existing” Medicaid funds based on States’ refusal to comply with the expanded Medicaid program. Ante, at 55. For the foregoing reasons, I disagree that any such withholding would violate the Spending Clause. Accordingly, I would affirm the decision of the Court of Appeals for the Eleventh Circuit in this regard. But in view of THE CHIEF JUSTICE’s disposition, I agree with him that the Medicaid Act’s severability clause determines the appropriate remedy.

    That clause provides that “if any provision of [the Medicaid Act], or the application thereof to any person or circumstance, is held in- valid, the remainder of the chapter, and the application of such provision to other persons or circumstances shall not be affected thereby.” 42 U. S. C. §1303. The Court does not strike down any provision of the ACA.

    It prohibits only the “application” of the Secretary’s authority to withhold Medicaid funds from States that decline to conform their Medicaid plans to the ACA’s requirements. Thus the ACA’s authorization of funds to finance the expansion remains intact, and the Secretary’s authority to withhold funds for reasons other than noncompliance with the expansion remains unaffected.

    Even absent §1303’s command, we would have no warrant to invalidate the Medicaid expansion, contra post, at 46–48 (joint opinion of SCALIA, KENNEDY, THOMAS, and ALITO, JJ.), not to mention the entire ACA, post, at 49–64 (same).

    For when a court confronts an unconstitutional statute, its endeavor must be to conserve, not destroy,the legislature’s dominant objective. See, e.g., Ayotte v. Planned Parenthood of Northern New Eng., 546 U. S. 320, 328–330 (2006). In this case, that objective was to increase access to health care for the poor by increasing the States’ access to federal funds.

    THE CHIEF JUSTICE is undoubtedly right to conclude that Congress may offer States funds “to expand the availability of health care, and requir[e] that States accepting such funds comply with the conditions on their use.” Ante, at 55. I therefore concur in the judgment with respect to Part IV–B of THE CHIEF JUSTICE’s opinion.

    * * *

    For the reasons stated, I agree with THE CHIEF JUSTICE that, as to the validity of the minimum coverage provision, the judgment of the Court of Appeals for the Eleventh Circuit should be reversed. In my view, the provision en- counters no constitutional obstruction. Further, I would uphold the Eleventh Circuit’s decision that the Medicaid expansion is within Congress’ spending power.



    [27] As THE CHIEF JUSTICE observes, the Secretary is authorized to withhold all of a State’s Medicaid funding. See ante, at 51. But total withdrawal is what the Secretary may, not must, do. She has discretion to withhold only a portion of the Medicaid funds otherwise due a non compliant State. See §1396c; cf. 45 CFR §80.10(f) (2011) (Secretary may enforce Title VI’s nondiscrimination requirement through “refusal to grant or continue Federal financial assistance, in whole or in part.” (emphasis added)). The Secretary, it is worth noting, may herself experience political pressures, which would make her all the more reluctant to cut off funds Congress has appropriated for a State’s needy citizens.
     
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    Uncensored2008 Libertarian Radical Supporting Member

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    What is your point in posting this? I don't think anyone who cares was unaware that Roberts held Obamacare as a tax.
     
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    Most everyone misquotes the SCOTUS ruling and it is a public document that can be searched here. It has legal arguments that contain the judicial philosophy and reasonings of some of the justices.This is a valuable resource for people who actually want to know where their own thinking process leads them. Some very brilliant discussion is contained in the dissents and concurring opinions as well as Roberts' own

    Roberts ruled part of the mandate, specifically the Shared Responsibility Payment functioned as a tax. It did not rule Obamacare a tax. The PPACA has many parts that were ruled on outside of the mandate. But then again, you pretend to know all of this even while misrepresenting the facts
     
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    What "facts" did I misinterpret?
     
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    Was the PPACA -- Known as Obamacare Ruled a Tax US Message Board - Political Discussion Forum
     

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