Washington DC — Tomorrow, as voters head to the polls, the Supreme Court of the United States will hear oral arguments in a case that could have disastrous impacts for the nearly 80 million Americans who receive their health care through Medicaid. Health and Hospital Corporation of Marion County v. Talevski, potentially “one of the most consequential health care cases in [the Supreme Court’s] history,” concerns whether individuals have the right to enforce provisions of the Medicaid law in court. If the Court rules against an individual’s right to sue, it would be reversing decades of precedent and put patients in danger of losing critical health care coverage. An adverse ruling in this case could also implicate the rights of beneficiaries across a broad range of state-administered public programs, including Supplemental Nutrition Assistance Program, child welfare, and federal public housing benefits. In response, Protect Our Care’s Policy and Health Equity Senior Advisor Anne Morris Reid issued the following statement:
“A negative ruling in this case would have devastating impacts for the tens of millions of Americans who rely on Medicaid for their health coverage – with particularly severe consequences for the pregnant women, children, people of color, people with disabilities and other low-income Americans this program serves. The defendants in this case are asking the Supreme Court to strip patients of their rights to seek targeted and rapid relief when they lose or are denied health coverage. If the case is successful, it will make it easier for Republicans to undermine and play politics with Medicaid. The Supreme Court must not overturn a half century of precedent and take away the most powerful tools beneficiaries have to hold state officials or health providers accountable.”
Who is the Plaintiff? Susie Talevski is a resident of Valparaiso, Indiana, and the daughter of a man who died in a nursing home facility. Gorgi Talevski, Susie’s father, resided in a nursing home 24/7 where he was supposed to receive care for his dementia. According to the family, he was chronically overmedicated in order to keep him asleep, his dementia wasn’t properly managed, and he was transferred to multiple different facilities hours from his family without his or the family’s consent. Susie brought a lawsuit against the defendants in 2019.
Who Are the Defendants? The Health and Hospital Corporation (HHC) of Marion County, jointly run by local government officials in Indiana and a private corporation that manages nursing homes within the state, is currently being accused of violating several provisions of federal law governing nursing homes. One of these provisions allegedly violated by the HHC is a prohibition on chemically restraining patients against their will either for convenience or disciplinary purposes.
What Are the Defendants Calling For? The defendants are not arguing whether or not there was wrongdoing in Mr. Talevski’s care but instead have taken an aggressive stance in this case, calling on the Supreme Court to fundamentally change the policies dictating Medicaid enforcement nationally. Throughout the process of this lawsuit, the HHC has claimed that Susie Talevski has no right to sue and has worked to get the case dismissed. Federal courts have sided with Talevski in every single case, forcing the HHC to bring this lawsuit all the way up to the Supreme Court.
What is at Risk? The Supreme Court is now presiding over the most consequential dual civil rights and Medicaid enforcement case ever. If they side with the defendants, this would establish a precedent making Medicaid requirements practically unenforceable. The federal government has limited authorities to enforce the rights of beneficiaries, with its primary enforcement method, withholding funding from non-compliant states, more likely to hurt beneficiaries than the states themselves. Due to this, Medicaid programs rely on private suits as its primary method of beneficiary protection. Additionally, stripping away a private citizen’s right to the courts when their rights have been violated is a critical part of the Civil Rights Act of 1871 and a decision siding with the HHC would effectively see the courts rewriting over 150 years of settled legal precedent on the nature of fundamental rights guaranteed to all Americans.