Abstract
National Federation of Independent Businesses v. Sebelius reshaped unconstitutional coercion jurisprudence: creating a three-part test for unconstitutional coercion while leaving the limits of the test undefined. Courts and commentators, faced with the confusion of applying Sebelius, have struggled to determine when and if Sebelius should apply. Stepping into this quagmire, this Comment applies the Sebelius rationale to Estate Recovery Programs (ERPs), a mandatory feature of Medicaid.
Every year, millions of Americans are impacted by ERPs. The main feature of ERPs is the seizure of a Medicaid patient’s estate following their death to repay the cost of providing medical care. When states effectuate recovery, decedents’ families are often left shocked, unaware the state could take their family home. Notably, ERPs exacerbate existing wealth disparities and are linked to reduced access to healthcare, as knowing patients avoid Medicaid to escape the ERP.
ERPs are ideal for exploring the limits of Sebelius because, to induce adoption of the ERP requirement, Congress and the Department of Health and Human Services threatened to end existing state Medicaid grants. This threat is the same inducement contemplated in Sebelius and held to be unconstitutionally coercive. To resolve the confusion about Sebelius, this Comment first presents a brief history of Medicaid. Then, it traces the development of ERPs and the impact of the requirement. The next section analyzes ERPs under the Sebelius coercion standard. Using this analysis, this Comment posits that the Sebelius coercion standard could apply to various federal programs and argues states should cease their ERPs.
Recommended Citation
Isabella M. Ryan,
Don't Go Changing to Try to Please Me: Understanding Sebelius via the Unconstitutional Coercion of Medicaid Estate Recovery Programs,
74
Emory L. J.
205
(2024).
Available at:
https://scholarlycommons.law.emory.edu/elj/vol74/iss1/5