Saturday, May 23, 2015
I'd hoped by now that King v. Burwell, argued March 4, would have been decided by now (but unsurprisingly it has not). Armstrong v. Exceptional Child Center was decided in late March. InArmstrong, the Court rejected the 9th Circuit's approach to challenges to low Medicaid reimbursement rates. The 9th Circuit had held that providers could bring suit under the Supremacy Clause arguing that state decisions conflicted with federal law, specifically section 30(A) of the Medicaid Act's requirement that reimbursements be sufficient for Medicaid recipients to receive care to the same extent as others in the community. The Court held that the Supremacy Clause is a rule of decision about which law to apply, not a source for substantive rights. But the Court went further, also concluding that section 30(A) leaves discretion about approval of Medicaid reimbursement with the Secretary of HHS and does not permit courts to consider equitable remedies in these cases. Medicaid providers are understandably disturbed by the decision, and advocates for Medicaid recipients are worried that broad language in the decision will preclude remedies for them as well. Whatever happens in King v. Burwell, Medicaid is sure to remain a thorny legal issue for the near future at least.