The Courts and the Congress

The initial vagueness in the Medicaid legislation compelled the courts to play a significant role in the various battles surrounding Medicaid. The Court was available to develop the policies which Congress was reluctant to clarify and to implement effectively those policies which state welfare departments implemented with conventional caution. The idea that the different Medicaid categories were so irrational as to amount to a denial of equal protection under the Fourteenth Amendment of the Constitution was first floated before Judge Motley in O&s;Reilly v. Wyman . The Congressional tax committees, meanwhile, were continuing efforts to make Medicare and Medicaid more productive and effective, and numerous proponents of national health insurance were suggesting schemes which differed radically among themselves, would add to health care expenditures. Welfare activists may be able to win court battles, but the wars have to be fought in the legislature.