Nov 9, 2022 - Health

SCOTUS seems unlikely to gut suing rights of Medicaid recipients

Illustration of a column wrapped in snakes from a caduceus.

Illustration: Shoshana Gordon/Axios

Supreme Court justices on Tuesday appeared unsympathetic toward an effort to bar Medicaid beneficiaries from suing for benefits the safety net program promises.

Driving the news: During oral arguments in a closely watched case, justices rebuffed claims that Medicaid is off-limits from “Section 1983” — a Reconstruction-era law that allows people to enforce civil rights violations by suing state officials in federal court.

  • But the court appeared torn over whether nursing home residents were guaranteed rights under a 1987 nursing home law that sets quality standards for facilities, or whether they should pursue remedies through a separate administrative process.

Catch up quick: The case, Health and Hospital Corp. v. Talevski, was brought by the wife of Medicaid patient with dementia, who sued his Indiana nursing home for alleged abuse.

  • The nursing home argued that federal rules for Medicare and Medicaid recipients originate from the government's spending powers and amount to contracts between the government and providers, so individuals can't sue.

Why it matters: Ruling in favor of that argument would strip millions of beneficiaries from going to federal courts if states violate their rights, said Sara Rosenbaum, a health law professor at George Washington University.

  • These violations can include negligence or denial of Medicaid coverage when eligible.
  • A decision could also have ramifications for other safety net programs like CHIP, child welfare or the Supplemental Nutrition Assistance Program.

Between the lines: Some justices appeared reluctant to overturn longstanding precedent and block such suits.

  • Justice Ketanji Brown Jackson said it was “odd to suggest that we, as a court, can reinterpret the word law in section 1983 to carve anything out.”
  • Justice Amy Coney Barrett, a conservative Trump appointee, said she could not “see the connecting of the dots” in the argument to disallow the suit.

Bottom line: “My chief takeaway was skepticism at every turn regarding the state’s argument about nursing home rights,” says Rosenbaum. “And much more fundamentally, a seeming unwillingness to engage on the state’s most explosive claim, which was that Medicaid just cannot be enforced through 1983.”

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