"The question is whether individual Medicaid beneficiaries may sue state officials under 42 U. S. C. §1983 for failing to comply with the any-qualified-provider provision. "
The answer is NO, according to the six right wing Catholics on the Supreme Court for whom the Beatitudes are no longer operational. Kagan, Sotomayor, Jackson dissent. - GWC
CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT No. 23–1275. Argued April 2, 2025—Decided June 26, 2025
Congress created Medicaid in 1965 to subsidize state healthcare for families and individuals “whose income and resources are insufficient to meet the costs of necessary medical services.” §1396–1. Medicaid offers States “a bargain”: federal funds in exchange for compliance with congressionally imposed conditions. To participate in Medicaid, States must submit a “plan for medical assistance” satisfying over 80 conditions in §1396a(a). If a State fails “to comply substantially” with any condition, the Secretary of Health and Human Services may withhold federal funding. §1396c. This case involves the any-qualified-provider provision in §1396a(a)(23)(A), which requires States to ensure that “any individual eligible for medical assistance . . . may obtain” it “from any [provider] qualified to perform the service . . . who undertakes to provide” it. The provision does not define “qualified,” leaving that to States’ traditional authority over health and safety matters. The question is whether individual Medicaid beneficiaries may sue state officials under 42 U. S. C. §1983 for failing to comply with the any-qualified-provider provision.
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