In the District Court and again in the Ninth Circuit Court of Appeals, our claims were dismissed. The Ninth Circuit’s 2005 decision was the first time that a Court of Appeals ruled that Medicaid’s equal access provisions were not enforceable in lawsuits brought by Medicaid providers and recipients. The Courts also ruled that California’s plan to move residents out of institutions and provide community services met its legal requirements, even as thousands of people with developmental disabilities remained in institutions against their will or struggled to obtain necessary services in the community.