Dozier v. Haveman
| Decision Date | 29 October 2014 |
| Docket Number | Case No. 2:14-cv-12455 |
| Parties | MAYA DOZIER, KRICKETT LUCKHARDT, and MICHELLE MACKAY, Plaintiffs, v. JAMES K. HAVEMAN, in his official capacity as Director of the Michigan Department of Community Health; and MAURA D. CORRIGAN, in her official capacity as Director of the Michigan Department of Human Services, Defendants. |
| Court | U.S. District Court — Eastern District of Michigan |
Honorable Laurie J. Michelson
Mag. Judge Michael J. Hluchaniuk
This case arises out of the State of Michigan's winding down of the Plan First! Family Planning Program, a Medicaid program that covered family-planning services, and the ramping up of the Healthy Michigan Plan, a Medicaid program that provides more comprehensive healthcare benefits. Plaintiffs Maya Dozier, Michelle Mackay, and Krickett Luckhardt allege that the Michigan Department of Community Health and the Michigan Department of Human Services ("the Departments") violated federal law by terminating the Plan First! program without first determining whether each Plan First! enrollee was eligible for another Medicaid program such as Healthy Michigan. Plaintiffs further allege that the notices the Departments sent to Plan First! enrollees informing them of the program's termination and its effect on their Medicaid eligibility lacked details required by the Medicaid Act, its implementing regulations, and the DueProcess Clause. Plaintiffs believe that the notices should have provided a detailed explanation for the Plan First! enrollee's ineligibility for other Medicaid programs such as Healthy Michigan. This, Plaintiffs assert, would have allowed the enrollee to make an informed decision about whether to appeal the Departments' Medicaid eligibility determination.
On June 23, 2014, just seven days before the Plan First! program expired, Plaintiffs filed this suit asking this Court to immediately certify a class of tens-of-thousands of Plan First! enrollees who had allegedly received inadequate pre-termination process, to order Defendants to provide that process, and to enjoin Defendants from terminating the proposed class members' Plan First! benefits until it could be finally determined whether Michigan's phase out of Plan First! complied with federal law. The Court promptly conferred with all counsel and a stipulated order ensued. (See Dkt. 17, Stipulated Order.) Under that order, the Departments agreed to extend Plan First! benefits pending this Court's decision on Plaintiffs' preliminary-injunction motion. (Id.)
Pending before the Court is Plaintiffs' motion for class certification and Plaintiffs' motion for preliminary relief on behalf of their proposed class. Shortly after these motions were filed, and before this Court had an opportunity to decide them, this case took a significant turn: the Departments enrolled each of Dozier, Luckhardt, and Mackay in Healthy Michigan. Plaintiffs will thus continue to receive the Medicaid coverage they sought regardless of how this case ends. Additional former Plan First! enrollees sought to intervene as class representatives, but the Departments subsequently enrolled them in Healthy Michigan too. Nonetheless, having carefully considered the issue of mootness and the effect of Plaintiffs' coverage on the Federal Rule of Civil Procedure 23 requirements forclass certification, this Court will grant in part Plaintiffs' motion to certify the class. By separate opinion an order, the Court will grant Plaintiffs' motion for preliminary relief.1
Three Michigan Medicaid programs are relevant to this case: traditional Medicaid, a now-terminated waiver program known as Plan First! Family Planning Services, and a waiver program known as the Healthy Michigan Plan. The following brief description of each provides the background necessary to understand Plaintiffs' class-action allegations.
In 1965, Congress established Medicaid "to provide federal and state funding of medical care for individuals who cannot afford to cover their own medical costs." Hughes v. McCarthy, 734 F.3d 473, 475 (6th Cir. 2013). Prior to the program's recent expansion under the Patient Protection and Affordable Care Act, Medicaid was primarily available to certain categories of people: pregnant women, children, needy families, the blind, the elderly, and the disabled. See Nat'l Fed'n of Indep. Bus. v. Sebelius, --- U.S. ---, 132 S. Ct. 2566, 2581-82, 2601, 183 L. Ed. 2d 450 (2012) (citing 42 U.S.C. § 1396a(a)(10)). Medicaid covers a number healthcare expenses for eligible individuals, including hospital, physician, and family-planning services. See Medicaid.gov, Medicaid Benefits, http://goo.gl/0l7Ct (last visited July 25, 2014). Until earlier this year, Michigan residents seeking Medicaid completed a comprehensive assistance form, DHS-1171.
In 2004, Michigan requested a waiver from the Center for Medicare & Medicaid Services to operate an optional Medicaid program: the Plan First! Family Planning Program. CMS approved the Departments' request and enrollment began in 2006. (See id. Pg ID 269-71.) Plan First! provided family-planning services such as contraceptives and physical examinations for reproductive health to women who were not eligible under any other Medicaid category and were between 19 and 44 years of age and had income below 185% of the federal poverty level. (Id. at Pg ID 269.) Prior to January 25, 2014, women applied for Plan First! by completing either the DHS-1171 comprehensive assistance form or a less comprehensive application specific to Plan First!. (Roderick Aff. ¶ 5.) "Because eligibility for Plan First! required, in part, that applicants not otherwise be eligible for Medicaid, the Plan First! application did not request extensive tax or other information required to determine eligibility for other Medicaid categories."
Beginning in January 2014, the Affordable Care Act effected a number of changes to the Medicaid program. For one, Medicaid was expanded to cover adults under the age of 65 with incomes at or below 133% of the federal poverty level. See 42 U.S.C. § 1396a(a)(10)(A)(i)(VIII); Nat'l Fed'n of Indep. Bus., 132 S. Ct. at 2582, 2601. "In Michigan, this expanded coverage was implemented as [Healthy Michigan]." Unlike Plan First!, Healthy Michigan is a comprehensive medical plan covering primary-care visits, inpatient and outpatient hospital visits, and prescription medications—as well as family-planning services. Michigan.gov, Healthy Michigan Plan Handbook, available at http://goo.gl/BQYcPt (last visited July 27, 2014). For another, the Affordable Care Act required states to begin determining an individual's financial eligibility for Medicaid using a Modified Adjusted Gross Income calculation. Department of Health and Human Services, MAGI:Medicaidand CHIP's New Eligibility Standards, available at http://goo.gl/DJQ9TR (last visited Aug. 29, 2014). In accord with these changes to Medicaid, as of January 25, 2014, Michigan residents interested in Medicaid were required to complete a new, Medicaid-only application, DCH-1426, instead of the comprehensive assistance form. (See Roderick Aff. ¶ 5.)
On April 1, 2014, Healthy Michigan opened to new enrollees. (Defs.' Resp. to Mot. for Class Cert. at 1.) Additionally, as of that date, the individual mandate of the Affordable Care Act required people making more than 133% of federal poverty levels to sign up for minimum essential healthcare coverage. Given the joint operation of Healthy Michigan and the individual mandate, the Departments concluded that Plan First! would no longer be necessary:
As a result of the expanded coverage available under the ACA, which includes family-planning services to [Healthy Michigan] recipients, the Plan First! program was no longer necessary, as the majority of the Plan First! population potentially would be eligible for this more comprehensive health coverage. Furthermore, Plan First! recipients above 133% of the federal poverty level (FPL) that were not eligible for [Healthy Michigan] were required under the ACA's individual mandate to sign up for minimum essential healthcare coverage by the end of open enrollment on March 31, 2014. 26 U.S.C. § 5000A.
In preparing to phase out the Plan First! program, the Departments, although they maintain that federal law did not require them to do so, conducted an ex parte review of some, but not nearly all, of the Plan First! enrollees to determine if they could be placed in another Medicaid program. (Defs.' Resp. to Mot. for Class Cert. at 1-2.) Simply stated, the Departments evaluated only those Plan First! enrollees who had completed either the comprehensive assistance form or the successor Medicaid-only form; the Departments did not reevaluate those who had completed only the Plan First! application. (See id. at 2-4, 10.)
Less simply stated, the Departments describe their processing of Plan First! enrollees in terms of "groups." According to Defendants, "Group A" consists of those enrollees who applied for Plan First! before January 25, 2014 using the Plan First! application. At oral argument, Defendants informed the Court that Group A consisted of approximately 32,000 Plan First! enrollees.2 "Group B" are those enrollees who applied for Plan First! after January 25, 2014 using either the...
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