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ROBERT SIEGEL, HOST:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

MELISSA BLOCK, BYLINE: And I'm Melissa Block. We've heard about how the Supreme Court's decision to uphold the health-care law could affect the federal Medicaid program and President Obama's political standing, but days after the historic ruling, lawyers say they're still teasing out the consequences for other key areas of the law, including civil rights. NPR's Carrie Johnson has that story.

CARRIE JOHNSON, BYLINE: At first blush, it might seem odd that a case about the Affordable Care Act would send civil rights experts back to the law books. But the Supreme Court's ruling in the health-care case involves parts of the Constitution that form the backbone of anti-discrimination laws, including the landmark 1964 Civil Rights Act. That law was designed to force businesses, like restaurants and hotels, to stop discriminating against black customers.

Congress used the Constitution's commerce clause, which gives the federal government power to regulate commerce between nations and states. Washington lawyer Robert Driscoll.

ROBERT DRISCOLL: The commerce clause, and the impact on interstate commerce of various types of discrimination, has traditionally formed the basis for many civil rights statutes.

JOHNSON: In the health-care decision, five justices - including the chief, John Roberts - put important limits on the commerce clause for the first time in decades, raising questions about the implications for federal civil rights legislation. But it's the second area of the ruling - the one that talks about new limits to the spending clause - that's really got civil rights lawyers' attention.

The federal government uses the spending clause to force states that accept certain federal money - for education or training, say - to agree not to discriminate on the basis of disability, race or gender. Robert Driscoll.

DRISCOLL: A lot of civil rights enforcement is done through federal spending statutes. And the spending clause is as important to civil rights enforcement as, frankly, the equal protection clause - or anything else the federal government has.

JOHNSON: A decade ago, several states sued, arguing Congress had gone too far under its spending authority. Kevin Russell defended those conditions for the Justice Department back then. Now, he thinks states are likely to revive those lawsuits, armed with the Supreme Court's reasoning in the health-care case. Seven justices found that a threat to withdraw all Medicaid funds for states that reject the Affordable Care Act, amounted to unlawful coercion.

KEVIN RUSSELL: Because the Supreme Court didn't give much guidance about what a test is for unconstitutional coercion, this - lower courts are going to have to figure it out for themselves. And some of the courts are, I think, going to be more sympathetic to coercion claims than others.

JOHNSON: But Russell predicts that even if lower courts strike them down, most civil rights laws will survive scrutiny from the Supreme Court.

RUSSELL: The court went to great length, in its health-care decision, to talk about how special and unique the Medicaid expansion was; and seemed to be going out of its way to try to limit the scope of the holding.

JOHNSON: Special and unique - that language is prompting some Supreme Court veterans, like Andrew Pincus, to be cautious about drawing big conclusions from the health-care case.

ANDREW PINCUS: It's sort of surprising to me, because if you think back to the arguments that were being made before the court's decision, both the commerce clause and the spending clause challenges to the law were based on the idea that what Congress had done was unprecedented.

JOHNSON: In other words, the Affordable Care Act was an unusual exercise of federal power, one that could remain unusual for some time.

Carrie Johnson, NPR News, Washington.

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