In December 2014, Law Center attorney Benjamin Geffen and pro bono attorneys from Boies, Schiller & Flexner LLP filed an amicus brief on behalf of the American Medical Association and other professional associations in Richard Armstrong, et al., v. Exceptional Child Center, Inc., et al.

UPDATE (3/31/15): The Supreme Court in a 5-4 decision decided not only that the Supremacy Clause cannot be used, but that there isn’t any vehicle at all for enforcing this provision, including via Section 1983 or as an implied cause of action. The Court’s reasoning will certainly cause problems in the future for people trying to enforce other parts of Medicaid.

Drawing on our decades of experience litigating to improve access to healthcare under Medicaid, seven professional provider groups engaged the Law Center to file a “friend of the court” brief in this lawsuit.

The Medicaid Act requires states to reimburse doctors and dentists at rates that are sufficient to ensure that the care and services available to Medicaid patients are equal to the care and services enjoyed by privately ensured individuals. Unfortunately, many states fall far short of meeting this “equal access” requirement, making it difficult or impossible for Medicaid enrollees to find doctors and receive desperately needed treatment. In a series of lawsuits dating to the early 1990s, the Law Center has challenged insufficient Medicaid provider rates in Pennsylvania, California, Michigan, Oklahoma, and Florida. By forcing states to boost reimbursement rates, such private lawsuits increase the number of providers accepting Medicaid, expanding access to healthcare.

In the Armstrong case, providers sued Idaho’s Medicaid agency for violating the “equal access” requirement. Because Ninth Circuit precedent closed off all other avenues for legal relief, the providers invoked the Supremacy Clause of the U.S. Constitution, which says federal laws such as the Medicaid Act preempt inconsistent state laws and regulations. Our amicus brief supports the Ninth Circuit’s holding that providers can sue under the Supremacy Clause. The amicus brief highlights the link between low provider rates and poor access to Medicaid services, and it demonstrates how private litigation has been necessary to narrow the access gap. Our brief also urges the Supreme Court not to disturb precedents that have made possible different forms of private enforcement of the Medicaid Act.

Click here for more information on this case

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Case Documents

• Brief for the Petitioners
• California Health and Human Services Agency amicus brief
• The States amicus brief
• National Governors Association amicus brief
• United States amicus brief
• Respondents’ brief
• Law Center amicus brief
• America Association of People with Disabilities et. al amicus brief
• National Health Law Program amicus brief
• Former HHS Officials amicus brief
• Medicaid Defense Fund amicus brief
• Members of Congress amicus brief
• Constitutional Accountability Center amicus brief
• American Civil Liberties Union amicus brief
• American Medical Association et al. amicus brief
• US Chamber of Commerce amicus brief
• American Hospital Federation amicus brief
• American Network of Community Options amicus brief
• Reply Brief for Petitioners
• Decision

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