Most Supreme Court justices seemed unlikely to embrace a truly outlandish legal argument presented to them Tuesday that could have destroyed the Medicaid program that provides health coverage to more than 76 million low-income Americans.
In that case, Health and Hospital Corporation of Marion County v. Talevski, the defendants asked the judges to stop allowing Medicaid patients to sue in order to enforce the program’s standards — a move that would have rendered the entire Medicaid law almost completely unenforceable. Fortunately for the tens of millions of Americans who rely on Medicaid, it seemed unlikely that most judges would bite into these arguments. Although, based on Tuesday’s arguments, as many as three judges can still sign for this large-scale attack on Medicaid.
While several judges appeared to be conflicted over whether nursing home residents can sue to enforce their rights under Medicaid law, or whether they should pursue their grievances through an administrative process separate from the federal justice system, only judges Clarence Thomas and Samuel Alito openness to the Talevskic the defendants’ most radical claims (though it’s worth noting that Judge Neil Gorsuch, who often votes with Thomas and Alito, was silent).
the plaintiffs in Talevskic allege that a nursing home overseen by local government officials in Indianapolis, Indiana, has violated several provisions of federal law protecting nursing home residents — including one that prohibits those facilities to use psychotropic drugs “for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.” It is still possible that they will lose their case on limited grounds – the Court could rule that nursing home residents may only use the administrative process to enforce Medicaid law.
But the catastrophic outcome for low-income Americans that the… Talevskic suspects sought in their letter seems unlikely.
The Talevskic Defendants Want to Make Federal Medicaid Law Almost Completely Impeachable
Medicaid is a “conditional grant” program, meaning that the federal government provides a significant amount of money to each state, but the states can only have this money if they agree to a long list of conditions. For example, states that accept Medicaid funds must: provide a long list of groups who are eligible based on their income, age, disability or family circumstances. States must also comply with more detailed rules governing how Medicaid-funded facilities must operate — such as the nursing home rules addressed in Talevskic.
Under current law, at least some of the requirements set forth in the Medicaid Act can be enforced through lawsuits filed in federal court. For example, if a state refuses to provide Medicaid coverage to someone legally entitled to it, that person would file a lawsuit to obtain the benefits guaranteed by law.
Congress has explicitly authorized these kinds of lawsuits in a Reconstruction-era law known as “Section 1983which states that state officials — and, in certain circumstances, private individuals who run state programs — can be sued in federal court if they deprive someone of “any rights, privileges or immunities guaranteed by the constitution and laws.”
Moreover, the argument that Section 1983 allows lawsuits to enforce the Medicaid law is extremely simple. Section 1983 allows lawsuits against certain individuals who violate rights “protected by the constitution and laws”. Medicaid laws are laws, even if they only apply to institutions that receive federal Medicaid funding.
Nevertheless, the Talevskic defendants made the historically dubious claim that Section 1983 lawsuits should not be used to enforce Medicaid law because similar lawsuits were not allowed under 19th-century contract law. (If that argument sounds weak, it’s because it’s extremely weak. I’ll go into more detail about the defendants’ arguments and why they’re wrong here.)
But only Thomas and, to a lesser extent, Alito expressed much sympathy for this dubious claim.
The three liberal judges, Sonia Sotomayor, Elena Kagan and Ketanji Brown Jackson, each took turns beating up the lawyers who attacked Medicaid — in a particularly brutal exchange, Jackson accused one of these lawyers of trying to “rewrite Section’s unequivocal language.” “. 1983.
Significantly, these liberal judges were joined at one point by Judge Amy Comey Barrett — a conservative Trump appointee — who told one of the anti-Medicaid attorneys that she “don’t see the connection between the points” in his landmark argument. .
Chief Justice John Roberts and Judge Brett Kavanaugh, meanwhile, barely mentioned whether the Medicaid bill is enforceable. They spent most of their questions researching how The Medicaid law must be enforced and whether the rules of the nursing home in question are in Talevskic must be enforced through Section 1983 lawsuits or through an alternative method.
In other words, Roberts and Kavanaugh seemed to believe that the defendants are wrong that the Medicaid bill is unenforceable.
In all honesty, if the Talevskic While the defendants’ most radical arguments prevailed, the federal government could still potentially impose sanctions on states that violate federal Medicaid law. Even in the absence of Section 1983 lawsuits, federal health officials have the authority to close some or all of Medicaid funds to states that violate the Medicaid statute.
In practical terms, however, this remedy is a paper tiger. The federal government has few resources to investigate Medicaid violations. And even if it discovers one, federal officials are extremely reluctant to cut off a state’s Medicaid funding for one obvious reason: Stopping Medicaid funding means the state has less money to spend on health care. to offer to people on low incomes. So if the federal government takes this action, it will essentially punish low-income patients for the misconduct of their state government.
But it appears that at least six members of the Supreme Court will leave the Medicaid program largely intact. It remains to be seen what the Supreme Court will say in its Talevskic opinion, but a disastrous outcome for low-income patients now seems unlikely.