The Peculiar Lineup of Justices on the Medicaid Decision

The Medicaid portion of the ACA case shows how splintered the Supreme Court was in this case. Two liberal justices, Stephen Breyer and Elena Kagan, joined the section of Chief Justice Roberts' opinion concerning Medicaid. But three Justices do not make that the opinion of the Court. The four dissenters also argue that Congress went too far in attempting to coerce the states to accept the expansion of Medicaid by cutting off all Medicaid funds if they did not, but the dissenters do not reach the same conclusion about what the remedy should be and did not join Roberts' opinion on this or anything else. The four dissenters conclude that the entire ACA should be declared unconstitutional because of the problems they see with it. However, Justice Ginsburg in the section of her opinion dealing with Medicaid, with which Justice Sontamayor joined, agreed with the Chief Justice that the remedy for the Medicaid issue would be to limit the reduction in funds paid to a state rejecting the Medicaid expansion to the amount for reimbursing the state for the expansion. Ginsburg and Sontamyor, though, while agreeing to the remedy, did not agree that the original Medicaid provision was unconstitutional. This result is peculiar, to say the least.