The outcomes of two Medicaid-related lawsuits before the U.S. Supreme Court could substantially change the federal government's role in the program. In the first case -- the multistate lawsuit challenging the federal health reform law -- the plaintiffs argue that the Medicaid expansion, scheduled for 2014, coerces states to participate in the program. In the second case, which originated in California, the Supreme Court will determine whether individual beneficiaries and health care providers can sue states that make Medicaid cuts. Some legal observers say that if the Supreme Court rules in favor of the plaintiffs in both cases, federal law no longer will have significant influence on states' Medicaid operations, such as eligibility decisions, coverage requirements and health care providers' payments.