White House to State AGs: No 'Legitimate Constitutional Concerns' in Senate Health Care Bill

January 5, 2010 - 8:11 PM
The White House on Tuesday dismissed the concerns of 13 state attorneys general about the constitutionality of a clause in the Senate health care bill that singles out Nebraska for special treatment when it comes to covering the cost of expanding Medicaid coverage.
Robert Gibbs

White House Press Secretary Robert Gibbs at the daily White House press briefing on Tuesday, Dec. 22, 2009. (AP Photo/Susan Walsh)

(CNSNews.com) – The White House on Tuesday dismissed the concerns of 13 state attorneys general about the constitutionality of a clause in the Senate health care bill that singles out Nebraska for special treatment when it comes to covering the cost of expanding Medicaid coverage.

While stating that he had not read a letter from the attorneys general about the issue, White House Press Secretary Robert Gibbs nonetheless told CNSNews.com, “I do not believe that anybody has legitimate constitutional concerns about the legislation.”

To ensure Nebraska Senator Ben Nelson’s (D) support, Democratic Senate leaders included a provision in the health care legislation to permanently pick up the cost of expanding the number of patients on Medicaid in Nebraska. The bill also covers the full cost of Medicaid expansion for the other 49 states, but only for the first three years.

Attorneys general in 13 states signed a Dec. 30 letter to House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.) that was circulated by South Carolina Attorney General Henry McMaster. The letter labels the Nebraska deal the “cornhusker kickback” and says it is unconstitutional to require the taxpayers of 49 states to subsidize federal benefits for one state. Medicaid is a federal-state health insurance program for the poor. (See previous story.)

When asked by CNSNews.com about the letter from the attorneys general, White House Press Secretary Robert Gibbs said, “I have not seen the letter from the attorneys general” but “I do not believe that anybody has legitimate constitutional concerns about the legislation.”

When asked if President Barack Obama supported the Nebraska clause, which reportedly would save the state $45 million over a decade, Gibbs did not directly answer but told CNSNews.com, “He’s a supporter of the Senate bill, so I don’t know what that will lead you to conclude.”

Both the House and Senate bills increase the number of people eligible for Medicaid. The Senate bill would make anyone at 133 percent of the federal poverty level eligible. The House bill would make anyone at 150 percent eligible.
Sen. Ben Nelson

Sen. Ben Nelson, D-Neb., talks to reporters on Capitol Hill early Monday morning, Dec. 21, 2009, following a 60-40 cloture vote, which is the first step in passing a health care bill. (AP Photo/Harry Hamburg)

Both the House and Senate passed a version of health care reform in late 2009. Each chamber must now iron out their differences and vote on a final version of the legislation. If that version passes, it then would go to President Obama to sign into law.

The House bill includes a government-run health insurance plan (“public option”) that would compete with private insurers. It also specifically bans federal funding for any health plan that covers abortion.

The Senate bill does not have a government-run plan, and does allow for federal funding of health plans that cover abortion. Both bills mandate that employers provide and individuals carry health insurance, and that the government establish a “health care exchange” to allow individuals to choose from different insurance-coverage policies.

In their Dec. 30 letter to the Democratic leaders, the attorneys general wrote: “It has been reported that Nebraska Senator Ben Nelson’s vote, for H.R. 3590 [Senate health care bill], was secured only after striking a deal that the federal government would bear the cost of newly eligible Medicaid enrollees.”

“In marked contrast, all other states would not be similarly treated, and instead would be required to allocate substantial sums, potentially totaling billions of dollars, to accommodate H.R. 3590’s new Medicaid mandates,” reads the letter.

“As a practical matter, the deal struck by the United States Senate on the ‘Nebraska Compromise’ is a disadvantage to the citizens of 49 states,” the letter says. “Every state’s tax dollars except Nebraska’s, will be devoted to cost-sharing required by the bill, and will be therefore unavailable for other essential state programs.”

The letter also includes the signatures of attorneys general from Alabama, Colorado, Florida, Idaho, Michigan, North Dakota, Pennsylvania, South Dakota, Texas, Utah, Virginia and Washington state.