“Has Congress made an offer that the states could not refuse? That is the question that must be decided by this case.”

Jan. 17, 2012 — The American Civil Rights Union filed its sixth brief on Tuesday challenging the constitutionality of the Patient Protection and Affordable Care Act (ACA), otherwise known as ObamaCare.

The brief to the U.S. Supreme Court in States of Florida, et al v. United States Department of HHS, in support of Florida and 25 other states was authored by ACRU General Counsel Peter Ferrara. The brief argues that the law’s Medicaid provision violates the Coercion Doctrine, which holds that the national government may not force states to adopt policies with laws “so coercive as to pass the point at which ‘pressure turns into compulsion’ (South Dakota v. Dole, 1987).”

“This court has long recognized under the Coercion Doctrine that just as Congress has no enumerated power to order states to implement federal policies, it may not use its Spending Power to achieve the same result indirectly,” the brief notes.

ObamaCare orders the states to provide a vast increase in coverage in order to qualify for federal Medicaid funding and facilitate the individual mandate for everyone to purchase health insurance.

“The states are consequently exposed to liability for care demanded beyond what doctors and hospitals are willing to provide,” the brief states. “Given the extremely low fees Medicaid pays to doctors and hospitals, that liability is in the twilight zone at least, and potentially out of this world.”

Medicaid accounts for 40 percent of all federal funds granted to the states, 7 percent of all federal spending, and 20 percent of state budgets on average.

“There is no conceivable way that states retain a practical choice to forego such federal Medicaid financing…,” the brief argues. “Consequently, the ACA’s Medicaid expansion unconstitutionally violates the Coercion Doctrine, transgressing state sovereignty and the Constitutional framework of federalism.”

Download the brief here. (PDF)