Conyers, Slaughter, Crowlet, Nadler, & Jeffries : GOP Bill Singles Out NYS for Shared Medicaid Costs


 Members Release Legal Analysis Pointing to Provision’s Unconstitutionality

 Washington, D.C. – Today, House Judiciary Committee Ranking Member John Conyers, Jr. (D-MI), House Rules Committee Ranking Member Louise Slaughter (D-NY), Democratic Caucus Chairman Joe Crowley (D-NY), and House Judiciary Committee Members Reps. Jerrold Nadler (D-NY) and Hakeem Jeffries (D-NY) released a legal analysis prepared by the House Judiciary Committee Democratic staff demonstrating the unconstitutionality of the ongoing Republican plans to single out New York State for sharing Medicaid costs with its counties. The Members  released the following joint statement:

“House Republicans’ Trumpcare bill is nothing more than a tax cut for the wealthy masquerading as a ‘healthcare bill.’ If this bill were to become law, 24 million Americans would lose their insurance coverage, and seniors would face skyrocketing premiums. Even worse, to appease the extreme conservatives of the House Republican Freedom Caucus, the newly adopted manager’s amendment includes provisions eliminating Essential Health Benefits requirements such as maternity care, prescription drug and emergency coverage – essentially erasing protections for Americans with pre-existing conditions.

“In a desperate attempt to pass this unconscionable bill, Speaker Ryan and the House Republican leadership have offered to include the Faso-Collins amendment in order to gain the support of vulnerable New York Republican members. This blatant vote buying represents the worst side of Washington politics. In fact, many Republican Attorneys General called a similar provision in 2009 ‘constitutionally flawed’ and ‘violating the most basic and universally held notions of what is fair and just.’

“By singling out New York State – even though 15 other states have similar systems for sharing Medicaid costs — and forcing New York to give up its core sovereign power to decide how it will raise funds for its own share of Medicaid, this measure is unconstitutional. This is why we believe New York State would be well within its rights to challenge the provision in court, as Governor Cuomo has suggested.

“The irony of this buyout is that the payment supposedly being delivered in exchange for votes is the legislative equivalent of a check on a closed bank account. It will never deliver the promised benefit.

“Finally, it is also important to note that House Republican Leadership’s reckless attempt to cram Trumpcare through Congress is that according to the most recent CBO report, the Faso-Collins amendment has no or only incidental impact on the federal budget.  It should therefore be struck under reconciliation rules if this bill even reaches the Senate.”

The House Judiciary Democrats’ report is available here.


For the last 51 years, New York State has chosen to fund a portion of its share of the Medicaid Program by using funds from county property taxes.  Fifteen other states structure Medicaid funding through a similar legally authorized system.

The Faso-Collins amendment, being incorporated into the Manager’s amendment to H.R. 1628, the “American Healthcare Act of 2017,”  specifies that any State that had an allotment of Disproportionate Share Hospital (DSH) funds that was more than 6 times the national average, and that requires subdivisions with populations of less than 5,000,000 to contribute toward Medicaid costs, shall have its reimbursement reduced by the amount of contributions by such subdivisions. This effectively limits the application to New York State, and carves out New York City. Under the amendment, New York State is at risk of losing $2.3 billion of its $32 billion in Federal Medicaid funds.

The amendment would implicate Constitutional limits on the Federal Spending Power, the Due Process and Equal Protection Clauses and the Tenth Amendment (reserving all undelegated powers to the States) because it is not related to a legitimate Federal interest; no rational Federal purpose has been proffered for the provision which singles out New York for discrimination; and it severely intrudes on traditional state prerogatives, such as structuring taxing and spending authorities.  Under a series of Supreme Court cases these provisions would exceed Congress’s spending authority, violate the Equal Protection and Due Process Clauses, and violate Tenth Amendment principles.

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