Michigan Prepares to File Briefs in Appeal of Medicaid Case

Michigan will file briefs next week to defend a federal district court ruling that Medicaid beneficiaries and the federal government cannot go to federal court to sue states for denied benefits that the federal government requires, NPR's "Morning Edition" reports. Two years ago, a group of Michigan mothers sued the state, saying Michigan "systematically" failed to provide their children with "early and periodic screening, diagnosis and treatment" -- a package of Medicaid benefits. The suit alleged that the state failed to screen thousands of children in its Medicaid program for lead poisoning, provide routine vision and hearing tests and administer immunizations. Instead of ruling on that issue, federal Judge Robert Cleland asked for briefs on a "broader issue" -- whether federal courts had any role in enforcement of federal Medicaid rules on states. After reviewing the briefs, Cleland determined that although federal statutes are supreme over state statutes, laws that Congress enacts under its spending powers are not supreme over state laws. He added that Medicaid essentially is a contract between two equal, sovereign governments -- the federal and the state governments -- and neither beneficiaries nor the federal government has the right to seek enforcement of benefits through the federal courts. Cleland said that the only recourse for the federal government in such a case is to cut off all Medicaid funds to the state. Carol Isaacs, director of health legislation and policy development for the Michigan Department of Community Health, said Medicaid beneficiaries do have an administrative recourse when they believe they have been denied required benefits. Such beneficiaries can call a hotline to lodge a complaint or can ask for a "fair hearing."

Mounting an Appeal
Jennifer Clark, a lawyer representing the parents of the Medicaid beneficiaries, maintains that the Constitution says that "all" federal laws are supreme over state laws. She added, "Really what it means is that people who have rights under federal law can't enforce them." The Bush administration has sided with the parents of the Medicaid beneficiaries, stating that Cleland's decision is in "direct conflict" with previous Supreme Court decisions on states' rights. NPR reports that should the decision stand, the "practical effect" would be "the end of Medicaid as a source of guaranteed health benefits" (Totenberg, "Morning Edition," NPR, 7/26). An audio file of this report will be available online after noon EST July 26.