Can patients and health providers sue when a state decides to sharply cut costs linked to a program that provides health benefits to low-income people?

That’s the question Supreme Court justices considered on Tuesday, when the nation’s highest court opened its 2011-2012 term. Experts believe a decision will not be reached until sometime before in the Spring.

The case heard comes as uncertainty over a much bigger case looms over the court. The court is expected to hear a case in spring asking whether a 2010 healthcare law requiring nearly everyone in the country to buy health insurance is constitutional.

In Tuesday's case, if the Supreme Court sides with providers and patients, lawsuits over cuts to the Medicaid program could be pursued in other states around the nation.

Medicaid is a federal program which provides health services 50 million low income people. The program allows states to share the costs of health care with the federal government.

Healthcare providers, who are paid through the program, sued California after the state began cutting Medicaid reimbursement rates by up to 10 percent in an effort to reduce its budget costs.

The law requires states to keep reimbursement levels sufficiently high to allow providers to join the program.

California’s move was blocked in a federal appeals court, setting the stage for the Supreme Court review on Tuesday.

California and 31 other states joined by the Obama Administration say judges should not be able to make the decision.

States argue that the decision about cutting costs should be left to the U.S. Health and Human Services Department alone.

There was no consensus on Monday on the outcome by Justices hearing oral arguments from both sides, according to reports.

The case is Douglas v. Independent Living Center of Southern California.