Georgetown University Center for Children and Families: Armstrong v. Exceptional Child—The Supreme Court’s “Fairest Reading” Really Isn’t Fair

Georgetown University Center for Children and Families: Armstrong v. Exceptional Child—The Supreme Court’s “Fairest Reading” Really Isn’t Fair

By Jane Perkins

In 2009, the Exceptional Child Center and other providers of in-home supportive services for people with disabilities sued the Idaho Medicaid Director, Richard Armstrong, on the grounds that they were not being paid enough. According to the record in the case, the state set the providers’ rates based on how much it wanted to spend on the Medicaid program rather than on how much the in-home service actually cost. The providers wanted the court to order the Medicaid agency to set the rates according to a Medicaid Act requirement that states set Medicaid payments at a level “sufficient to enlist enough providers so that care and service are available under the [Medicaid] plan at least to the extent that such care and services are available to the general population in the geographic area.”

According to the record in the case, the state set the providers’ rates based on how much it wanted to spend on the Medicaid program rather than on how much the in-home service actually cost. The providers wanted the court to order the Medicaid agency to set the rates according to a Medicaid Act requirement that states set Medicaid payments at a level “sufficient to enlist enough providers so that care and service are available under the [Medicaid] plan at least to the extent that such care and services are available to the general population in the geographic area.”

To bring a lawsuit in federal court, the health care providers needed what’s called a “cause of action,” and for this, they relied on the Supremacy Clause of the Constitution. The Supremacy Clause says that federal law is the “supreme Law of the Land,” regardless of any contradictory state law. Nothing unusual here. Plaintiffs have filed Supremacy Clause actions for more than 200 years, and federal courts have enforced the Supremacy Clause to enjoin state laws that conflict with, and are thus preempted by, the U.S. Constitution or a federal law. Read the full article here. »

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