Major Supreme Court Victory for Medicaid Beneficiaries

Major Supreme Court Victory for Medicaid Beneficiaries

Talevski Ruling keeps the courthouse doors open for low-income people and preserves the ability of advocates to litigate on their behalf

Washington, DC – Today, the United States Supreme Court upheld the right of Medicaid beneficiaries to seek relief in federal court when their rights are being violated by state officials. Ruling 7 to 2 in Health and Hospital Corporation of Marion County, Indiana v. Talevski, the justices ruled in favor of the family of Gorgi Talevski, who sued alleging that his nursing facility’s use of chemical restraints and involuntary transfers violated the Medicaid provisions known as the Federal Nursing Home Reform Act (FNHRA). This ruling keeps the courthouse doors open for low-income people and preserves the ability of advocates to litigate on their behalf. 

“Today’s ruling will allow the National Health Law Program (NHeLP) to continue to use private enforcement as a mechanism to get low-income people the care they need. NHeLP has worked on the issue of private enforcement for the last 30 years, and knows that it is an indispensable tool in ensuring access to health care for underserved people,” said Sarah Somers, Legal Director at the National Health Law Program. “The fact is, states will fail to meet the requirements of the Medicaid Act – health care is complicated – but when states refuse to correct the problem, organizations like NHeLP must go to court to stop ongoing harm. The people we represent are low-income people, who need acute, preventive, long-term and other care, but for whom it may be out of reach without court intervention. Today’s ruling will allow us to continue representing the needs of these individuals in court.”

“Over the span of four decades, the Supreme Court has recognized that individuals have the right to enforce provisions of the Medicaid Act in court. As advocates for low-income people, we are relieved that the Court has upheld that right. This is a win for not only Medicaid beneficiaries but those who rely on states to implement housing, nutrition, education, disability, and a host of other federal laws,” said Jane Perkins, Litigation Director. “Today’s ruling signals that the judiciary will remain a powerful mechanism ensuring that people’s rights under safety-net programs are protected.”

“A judiciary responsive to the rights and needs of all people, not just the rich and powerful, is essential for a healthy democracy,” said Elizabeth G. Taylor, Executive Director at NHeLP.  “Today, low-income people and the advocates who represent them can breathe a sigh of relief knowing that the right to private enforcement remains for those who rely on federal programs like Medicaid. But we must remain vigilant. The fact that this case made its way to the Supreme Court at all, along with a flurry of cases unmoored from precedent, reveals the ongoing danger in federal judicial activism to restrict the rights of underserved people and communities. We reaffirm our commitment to robust access to equitable health care and are actively expanding our litigation capacity to ensure that NHeLP is prepared to navigate an increasingly fraught legal landscape.” 

“For decades, advocates in Indiana have used individual enforcement of federal spending clause legislation to ensure access to vital benefits and therapies,” said Adam Mueller, Executive Director at Indiana Justice Project, a non-profit legal advocacy organization and one of NHeLP’s Health Law Partnerships. “This includes broad access to medicines to cure hepatitis C, necessary dental benefits, and services and therapies for individuals of all ages with severe disabilities. This ruling will reaffirm that those rights may be vindicated in court.”

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