LEGAL TRENDS
threat to withhold existing Medicaid funds if States refused to participate in the expansion would be coercive. Furthermore, the Court disagreed with the Government’s claim that expansion should be viewed as a modification of the existing Medicaid program because, under ACA, it undergoes a transformation into a program that covers an entirely new population. The Court concluded that, pursuant to the Spending Clause, Congress could offer these funds associated with Medicaid expansion to the States and require them to comply with the conditions attached to their use, provided the State elected to participate. However, the Court found as unconstitutional the provision in ACA that allowed the Secretary of Health and Human Services to withhold a State’s existing Medicaid funding if the State elected to not participate in the expansion, but the Court was able to sever the unconstitutional provision as permitted by this section, thereby preserving the rest of the ACA. Effect on Health Care Delivery Despite the decision of the Court, several important measures have been set in motion. These include (1) provider consolidation/merger activity; (2) development and expansion of accountable care and other integrated provider organizations (“ACOs”); (3) use of ACOs as new insurance products by health plans; (4) performance and quality based reimbursement and incentives; and (5) health information/data sharing and management, all of which would have continued to evolve. Sheryl Tatar Dacso, J.D., Dr. P.H., a partner in the Houston office of Seyfarth Shaw, LLP, has represented health care organizations, hospitals and physicians for over 30 years. She is Board Certified in Health Care Law by the Texas Board of Legal Specialization and certified in health care compliance by the Health Care Compliance Association. The
author wishes to thank Courtney Duffy, 3L at Loyola University Law School in Chicago, Illinois for her work on this article.
Arizona v. United States A State’s Role in Immigration Enforcement
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By Marcos Gemoets exans understand the importance of sovereignty, particularly when it comes to protecting Texans and their land. The State holds little reservation in challenging efforts by the federal government to expand its role in what Texans believe to be state issues. However, when it comes to immigration, the federal government reigns supreme, as affirmed by the U.S. Supreme Court on June 25, 2012, in its landmark decision, Arizona v. United States. Immigration, in particular undocumented migration, remains a polarizing political, economic and social issue. States like Texas, New Mexico, Arizona and California, which share a southern border with Mexico, also share unique problems caused by the flood of undocumented migration passing through into the United States. In response to what is perceived to be an adverse impact on the economies, security and welfare of these states caused by this migration, several states have enacted laws and regulations intended to deter immigration and enforce federal immigration laws at a state level. In 2010, Arizona enacted The Support Our Law Enforcement and Safe Neighborhoods Act, commonly referred to as S.B. 1070, citing a need
to address an increased population of undocumented foreign nationals in the state and the economic and social impact caused by their presence. The Arizona statute established criminal penalties for immigration violations and authorized state law enforcement to detain foreign nationals for immigration violations. Arizona sought to stand in the place of federal immigration officers it considered unable or unwilling to detain unauthorized migrants in the state. The Constitution authorizes the federal government to establish a uniform naturalization process and create immigration laws that are consistent with the country’s domestic and foreign policies. The Immigration & Nationality Act (“INA”), providing the general framework for the implementation and enforcement of immigration laws in the United States, was enacted in 1952. Congress has amended the INA to include additional benefit and enforcement provisions, including a major overhaul of removal grounds in 1986 and 1996. These amendments introduced employer sanctions for willful employment of unauthorized foreign workers and enhanced grounds for the removal of foreign nationals. In Arizona v. United States, the U.S. Supreme Court affirmed the federal government’s role in immigration law, stating that “[i]mmigration policy can affect trade, investment, tourism, and diplomatic relations for the entire Nation, as well as the perceptions and expectations of aliens in this country who seek the full protection of its laws... It is fundamental that foreign countries concerned about the status, safety, and security of their nationals in the United States must be able to confer and communicate on this subject with one national government, not the 50 separate States.” The key issue in Arizona v. United States was whether states may regulate immigration within their respective borders, thehoustonlawyer.com
July/August 2012
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