High court hears California Medicaid reimbursements case

The likely review of certain aspects of the Obama health care bill may not be the U.S. Supreme Court’s only decision this term with potential to transform the American health care landscape.

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U.S. Supreme Court News

On October 3, the U.S. Supreme Court heard arguments in a case asking whether individuals have a right to sue states for federal law violations stemming from reduced Medicaid reimbursements rates.

In 2008, the California legislature approved a 10-percent reduction in Medicaid reimbursements rates for doctors and other health providers. A district court blocked the rate cuts from going into affect after a group of patients and providers filed a lawsuit charging that the reductions would result in fewer Medicaid providers and consequently, more people not receiving medical services the state is required to provide under federal Medicaid law.

The U.S. Department of Health and Human Services, which oversees state Medicaid programs, agreed and filed a lawsuit, currently pending in federal court, against California.

At the Supreme Court level, however, California is only arguing that federal Medicaid law bars individuals from bringing lawsuits over reimbursement rates because this power has not been specified by Congress, and is therefore limited to the federal government.

Many disability rights groups fear that a broad ruling in California’s favor could sharply limit the power of private individuals to keep states in check that are violating federal health care laws.

“Over the history of the program, private enforcement has been the primary means of halting ongoing state violations of federal law and realizing Medicaid’s promises and protections,” stated the National Disability Rights Network in an amicus brief on behalf of the patients providers, along with the AARPPlanned Parenthood and a host of disability advocacy groups.

Advocacy groups of all political stripes, including the American Civil Liberties Union, the U.S. Chamber of Commerce and House and Senate Democratic leaders, have also filed amicus briefs on behalf of the patients and providers, arguing that an individual’s power to file lawsuits against states violating federal laws is not a right that needs to be specified by Congress, but is instead an established aspect of federalism necessary to protecting civil, economic and political rights.

The U.S. Justice Department, in a surprise to many, filed an amicus brief with 31 other states on behalf of California, arguing that states need the flexibility to modify their Medicaid programs and the U.S. Department of Health and Human Services should have the sole power to keep the states in check.

In the hearing, the Supreme Court justices did not provide much guidance on how they  will rule. Justice Elena Kagan said the court has previously allowed individuals to sue states for violating other federal laws, according to an article by the National Law Journal. Chief Justice John Robert made clear his support for California’s argument, stating that Congress “intended to deprive (the providers) of the right to sue.”

Justice Anthony Kennedy, however, was dismissive of the U.S. government’s argument, that Congress’ intention was for the law to be interpreted by a single agency rather than 700 judges. He called it a “sky is falling,” argument.

DisAbility Rights Washington, the sponsor of DisAbility Rights Galaxy, is part of the federally funded protection and advocacy system and a member of the National Disability Rights Network.

One response to “High court hears California Medicaid reimbursements case

  1. If that’s not enough Medicare erroneously cut my benefits off after a number of Dr. referrals; SSA’s involvement which also misled me into a complete denial of all benefits after 4 years on SSA. Now I will be homeless in 4 weeks but, the gov did find a way to save money on my behalf.
    Your Welcome!


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