Supreme Court tackles Medicaid expansion today

Extreme disruption of Medicare funding forecast if Affordable Care Act is tossed out

The U.S. Supreme Court is scheduled to hear oral arguments today over whether the Affordable Care Act's expansion of Medicaid is constitutional.

Starting in 2014, the ACA requires states to expand their Medicaid programs to cover all individuals under the age of 65, who have incomes of up to 133% of the poverty level. States that do not comply will risk losing federal funding. In January, 26 states filed a brief encouraging the court to strike this part of the law by applying the coercion doctrine.

No matter what the high court decides, it will have ramifications for long-term care providers who substantially rely on Medicaid. Arguments regarding the Medicaid expansion are scheduled for 1:00 p.m. ET.

But first, the attorneys for each side will argue whether the law's individual mandate can be severed from health care reform in the event the court decides the mandate is unconstitutional. That would determine whether other ACA policies and regulations could stand if the mandate is thrown out.

On Tuesday, the justices heard arguments over the individual mandate, which requires Americans to have health insurance by 2014 or pay a penalty. While U.S. Solicitor General Donald B. Verrilli Jr. argued that Congress had the right to pass the individual mandate due to its power to regulate commerce and impose taxes, attorneys Paul Clement and Michael A. Carvin said it forces citizens to buy a product and enter a commercial market.

The court will not hear arguments this week over the employer mandate, which has been a hot topic in long-term care employer circles. Lower courts have found in favor of the Obama administration on this issue.

A decision on the healthcare reform law is expected in late June.