Two Courts Reject Westsider Mothers Decision, Enforce Medicaid Statute
Keywords
In Boudreau v. Ryan, No. 00-5392-011.MEV (N.D. Ill. May 1, 2001), the decision refutes Westside Mothers on virtually every point. In Antrican v. Buell, No. 4:00-CV-173(H)(4) (E.D. N. Car. Apr. 17, 2001), the court dismisses the essence of the Westside Mothers decision in a footnote, n. 5, saying,
Defendants argue that plaintiff, as third party beneficiaries of the Medicaid Act, may not seek enforcement under section 1983. Defendants' argument is without merit, and the court does not discuss it in detail.
Boudreau involved a claim that the state violated the Medicaid statute by denying services to developmentally disabled plaintiffs covered by the state Medicaid plan, namely Intermediate Care Facilities for the Mentally Retarded (ICF/MR). The court holds that the case is one for prospective relief and falls under Ex parte Young and that no special sovereignty issue is presented by operation of a state Medicaid program. It rejected the argument that Spending Clause legislation falls outside of the Supremacy Clause, noting Supreme Court decisions striking down state laws or regulations in AFDC cases, which had the same federal-state structure as the Medicaid statute. The court rejected the Westside Mothers rationale that all the plaintiffs were seeking is to enforce the contract between the state and federal government on the operation of the Medicaid program. This is a suit against state officers acting beyond their power in contravention of federal law. Further, since the claim is denial of services required by federal law, this is not a case involving state discretion.
The court did dismiss plaintiffs' claims under the Americans with Disabilities Act (ADA), because it was bound by the Seventh Circuit ruling in Walker v. Snyder, 213 F. 3d 344 (7th Cir. 2000), cert. den. 121 S. Ct. 1188 (2001), that claims under Title II of the ADA could only be brought against governmental entities, not state officials. But the court noted that footnote 9 of the subsequent decision of the Supreme Court in Board of Trustees of the Univ. of Alabama v. Garrett, 121 S.Ct. 955, 968 (2001) calls the Seventh Circuit decision into question.
The court went on to find that the provisions of the Medicaid statute in question were enforceable rights under 42 U.S.C. § 1983. The state argued that since the home and community waiver programs were limited to a specified number of persons, there was no right to participate. The court found that since the state admitted there were open slots in the program and plaintiffs were complaining of their exclusion from the program, plaintiffs had an enforceable right. It also held that plaintiffs' claims under Section 504 of the Rehabilitation Act of 1974 were enforceable through 1983.
The court also denied the motion to dismiss plaintiff's alleged violations of the Equal Protection and Due Process Clauses of the Fourteenth Amendment.
Antrican v. Buell involved claims that because of low reimbursement rates for dentists under the state Medicaid program, plaintiffs could not obtain Medicaid covered dental services in the geographic areas where they lived.
The court denied a motion to dismiss on 11th Amendment grounds. It found that the case sought only prospective relief. It rejected a claim that plaintiffs were asserting claims under state law. Although the reimbursement rates were set by the state, the issue was whether the rates complied with federal law. It also found no special sovereignty issues in the Medicaid program.
The court went on to find that almost all of plaintiffs' claims were for rights enforceable under Section 1983. These include claims for equal access and quality care (42 U.S.C. § 1396a(a)(30)(A)); statewide availability (42 U.S.C. § 1396a(a)(1)); reasonable promptness (42 U.S.C. § 1396a(a)(8)); comparability (42 U.S.C. § 1396a(a)(10)(B); and various sections of the EPSDT program.