Court Ruling Didn’t Affect “Maintenance-of-Effort” Requirement
The Supreme Court ruling on the Affordable Care Act only held that the law could not compel states to expand their Medicaid program or risk all of their federal Medicaid funding; it did not address the reform law’s maintenance-of-effort requirement, which is in effect until 2014.
So says the Congressional Research Service (CRS) in a July 16 memo prepared for several members of Congress.
According to CRS, the Supreme Court viewed the Medicaid expansion as a new program and its decision addressed only that new program. The maintenance-of-effort requirement, which prohibits states from tightening their Medicaid eligibility criteria before 2014, is part of the existing Medicaid program, CRS concluded, and therefore is not affected by the court decision that prevents the federal government from compelling states to expand their Medicaid programs. The memo states that
The Supreme Court’s decision does not make changes to the current Medicaid program. This point was made clear in the Court’s severability analysis when it said that “Congress would have wanted the rest of the Act to stand, had it known that States would have a genuine choice whether to participate in the new ACA Medicaid expansion.”29 This supports the interpretation that the MOE requirement and its enforcement by the potential loss of all current federal Medicaid matching funds “stands,” remaining untouched by the Court’s ruling.
Read the CRS memo here.