New York Times' editorial on State Rights argument in the Health Care Reform debate

Editorial

Health Care and the States

Published: November 22, 2011

In reviewing the constitutionality of health care reform, the Supreme Court said it would consider the legality of the Medicaid expansion included in the reform law. The question seems narrow, but it could have significant implications for redefining Congress’s spending power.

The only appellate court that even addressed this question, the United States Court of Appeals for the 11th Circuit, rejected the constitutional challenge. Having taken up the question, the Supreme Court should affirm that ruling. It would be a serious mistake for the court to use this case to restrict Congress’s authority by placing any additional requirements for the commitment of federal money.

The Constitution’s spending clause gives Congress the power to pay debts and “provide for the common defense and general welfare” of the country. In 1987, the Supreme Court held that when Congress provides money to a state, it has broad power to require states to meet conditions related to the money — as long as the spending serves the general welfare and meets other restrictions.