Judge Rules State May Not Be Sued Over Medicaid Benefits
A federal judge has ruled that Michigan state officials may not be sued in order to force them to provide medical benefits guaranteed under federal Medicaid law, the New York Times reports. U.S. District Court Judge Robert Cleland ruled that Medicaid is a "contract" between the federal government and the state of Michigan, and while Medicaid beneficiaries profit from the program they "have no right to enforce [Medicaid law] in court." Cleland noted that Congress has allowed for only one method of redress: The HHS secretary may withhold federal funding from states not meeting their Medicaid responsibilities. Cleland ruled that Congress "chose this 'specific limited remedy'" and that the "courts may not substitute an alternative form of relief." The case stems from a lawsuit filed in 1999 by a group of parents seeking a package of Medicaid benefits for their children known as "early and periodic screening, diagnosis and treatment" or EPSDT. The parents filed under a civil rights law known as Section 1983, which allows state officials to be sued for violating constitutional or federal law. However, Cleland ruled the statute did not allow lawsuits for failure to carry out the terms of a federal grant program, such as Medicaid. In addition, he ruled that state officials could not be held liable for "Michigan's breach of its Medicaid contract." Lawyers for the parents plan to appeal the decision. However, Sara Rosenbaum, a professor of health law and policy at George Washington University , said, "If the ruling stands, it is the end of the Medicaid program as a source of insurance. It makes Medicaid unenforceable by private individuals. The ability to enforce your right to benefits is the essence of insurance. Without that ability, you no longer have insurance." The Times reports that Illinois, North Carolina, Texas and other states have cited the ruling in similar cases (Pear, New York Times, 5/13). To read the full opinion, go to http://188.8.131.52/JudgesOpinions/Cleland/_Cleland.htm.