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Supreme Court preserves Medicaid recipients’ right to sue

Policy watchers call the decision a civil rights victory for Medicaid recipients

A pedestrian is seen near the U.S. Supreme Court on June 5. The court on Thursday ruled 7-2 to protect the right of Medicaid nursing home residents to seek relief in federal court when state officials do not meet a certain quality of care.
A pedestrian is seen near the U.S. Supreme Court on June 5. The court on Thursday ruled 7-2 to protect the right of Medicaid nursing home residents to seek relief in federal court when state officials do not meet a certain quality of care. (Alex Wong/Getty Images)

The Supreme Court on Thursday ruled 7-2 to protect the right of Medicaid nursing home residents to seek relief in federal court when state officials do not meet a certain quality of care — a ruling policy watchers are hailing as a civil rights victory for Medicaid patients.

In the case, Health and Hospital Corporation of Marion County v. Talevski, nursing home patient Gorgi Talevski’s wife, Ivanka, accused the Indiana health system of violating a 1987 federal law governing nursing homes that receive federal funding. The law includes a provision that prohibits nursing homes from using psychotropic drugs for nonmedical reasons. 

Gorgi Talevski moved to a nursing home in 2016, and in 2019 his wife, Ivanka Talevski, filed a lawsuit alleging he was inappropriately subjected to psychotropic drugs and involuntary transfers in violation of the federal nursing home law. Gorgi Talevski died in 2021.

While some of the legal requirements under the 1987 law can be enforced through lawsuits, the hospital system asked the Supreme Court to eliminate a Medicaid patient’s ability to bring forward such lawsuits, arguing that Medicaid patients don’t have standing because they are third parties in what is essentially a contract between the state and the federal government. 

The court denied their request.

Justice Ketanji Brown Jackson said that an 1870 statute protects enforcement actions taken by any person deprived of “any rights secured by the Constitution and laws,” and this statute still stands, despite the petitioners’ counterarguments.

“‘Laws’ means ‘laws,’ no less today than in the 1870s, and nothing in petitioners’ appeal to Reconstruction-era contract law shows otherwise,” Jackson wrote in the majority opinion.

Justices Samuel A. Alito Jr. and Clarence Thomas dissented from the decision.

Patient advocates are hailing the ruling as a victory for Medicaid enrollees, a group with high numbers of pregnant women, children, people of color and people with disabilities.

“A negative ruling in this case would have been devastating for the tens of millions of Americans who rely on Medicaid for their health coverage,” said Anne Morris Reid, the health equity senior adviser at the advocacy group Protect Our Care, adding “it is a relief that the Court’s decision protected the most powerful tools beneficiaries have to hold state officials or health providers accountable.”

Jane Perkins, litigation director at the National Health Law Program, which represents Medicaid enrollees, said the ruling could have far-reaching impacts not just for those on Medicaid but for individuals who rely on state housing, nutrition, education or disability services. 

“Today’s ruling signals that the judiciary will remain a powerful mechanism ensuring that people’s rights under safety-net programs are protected,” Perkins said.

The case also gives the federal government another way to enforce Medicaid requirements on states, noted Larry Levitt, executive vice president for Health Policy at  KFF, a health think tank formerly known as the Kaiser Family Foundation. Without the ability to sue, the federal government can only really enforce the Medicaid statute by withholding funding, something that is rarely done, he said.

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