Schweiker v. Wilson, 79-1380

• Court: United States Supreme Court
• Citation: 67 L.Ed.2d 186,450 U.S. 221,101 S.Ct. 1074
• Docket Number: No. 79-1380,79-1380
• Parties: Richard SCHWEIKER, Secretary of Health and Human Services, Appellant, v. Charles Edward WILSON et al
• Decision Date: 04 March 1981

450 U.S. 221 101 S.Ct. 1074 67 L.Ed.2d 186 Richard SCHWEIKER, Secretary of Health and Human Services, Appellant,

v.

Charles Edward WILSON et al.

No. 79-1380. Argued Dec. 2, 1980. Decided March 4, 1981. Syllabus

The Supplemental Security Income (SSI) program, which is part of the Social Security Act, provides a subsistence allowance to needy aged, blind, and disabled persons. Inmates of public institutions are generally excluded from this program, except that under § 1611(e)(1)(B) of the Act a reduced amount of SSI benefits are provided to otherwise eligible persons in a hospital, extended care facility, nursing home, or intermediate care facility receiving Medicaid funds for their care. Appellees, aged 21 through 64 and residing in public mental institutions that do not receive Medicaid funds for their care, brought a class action in Federal District Court challenging their exclusion from the reduced SSI benefits. The District Court held such exclusion unconstitutional as violative of the equal protection guarantees of the Due Process Clause of the Fifth Amendment on the ground that the "mental health" classification could not withstand judicial scrutiny because it did not have a "substantial relation" to the object of the legislation in light of its "primary purpose."

Held : Appellees' rights to equal protection were not violated by denying them SSI benefits. Pp. 230-239.

(a) In § 1611(e)(1)(B), Congress made a distinction not between the mentally ill and a group composed of nonmentally ill, but between residents in public institutions receiving Medicaid funds for their care and residents in such institutions not receiving such funds. To the extent that the statute has an indirect impact upon the mentally ill as a subset of publicly institutionalized persons, the record in this case presents no statistical support for a contention that the mentally ill as a class are burdened disproportionately to any other class affected by the classification. The indirect deprivation worked by this legislation upon appellees' class, whether or not the class is considered "suspect," does not, in the absence of any evidence that Congress deliberately intended to discriminate against the mentally ill, move this Court to regard it with a heightened scrutiny. Pp. 230-234.

(b) The classification employed in § 1611(e)(1)(B) is to be judged under the rational-basis standard, which does not allow this Court to

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substitute its personal notions of good public policy for those of Congress. Under this standard, and based on the legislative history, it was not irrational for Congress to elect, in view of budgetary constraints, to shoulder only part of the burden of supplying a "comfort money" allowance, leaving the States with the primary responsibility for making such an allowance available to those residents in state-run institutions, and to decide that it is the Medicaid recipients in public institutions who are the most needy and deserving of the SSI benefits. Pp. 234-239.

478 F.Supp. 1046, reversed.

Elliott Schulder, Washington, D. C., for appellant.

James D. Weill, Chicago, Ill., for appellees.

Justice BLACKMUN delivered the opinion of the Court.

The issue in this case is whether Congress constitutionally may decline to grant Supplemental Security Income benefits to a class of otherwise eligible individuals who are excluded because they are aged 21 through 64 and are institutionalized in public mental institutions that do not receive Medicaid funds for their care. The United States District Court for the Northern District of Illinois held unconstitutional, under

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the Due Process Clause of the Fifth Amendment, that portion of the Social Security Act, as amended, that excludes these otherwise eligible persons from the supplemental benefits. The Secretary of Health and Human Services has taken a direct appeal to this Court under 28 U.S.C. § 1252.

I

In October 1972, Congress amended the Social Security Act (Act) to create the federal Supplemental Security Income (SSI) program, effective January 1, 1974. 86 Stat. 1465, 42 U.S.C. § 1381 et seq. This program was intended "[t]o assist those who cannot work because of age, blindness, or disability," S.Rep.No.92-1230, p. 4 (1972), by "set[ting] a Federal guaranteed minimum income level for aged, blind, and disabled persons," id., at 12.¹

The SSI program provides a subsistence allowance, under federal standards, to the Nation's needy aged, blind, and disabled.² Included within the category of "disabled" under the program are all those "unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to

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result in death or which has lasted or can be expected to last for a continuous period if not less than twelve months." § 1614(a)(3)(A) of the Act, 42 U.S.C. § 1382c(a)(3)(A).

Although the SSI program is broad in its reach, its coverage is not complete. From its very inception, the program has excluded from eligibility anyone who is an "inmate of a public institution." § 1611(e)(1)(A) of the Act, as amended, 42 U.S.C. § 1382(e)(1)(A).³ Also from the program's inception, Congress has made a partial exception to this exclusion by providing a small amount of money (not exceeding $300 per year) to any otherwise eligible person in "a hospital, extended care facility, nursing home, or intermediate care facility receiving payments (with respect to such individual or spouse) under a State plan approved under subchapter XIX [Medicaid] . . ." § 1611(e)(1)(B), as amended, 42 U.S.C. § 1382(e)(1)(B).⁴ Congress thus, while excluding

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generally any person residing in a public institution, explicitly has tied eligibility for a reduced amount of SSI benefits to residence in an institution receiving Medicaid benefits for the care of the eligible individual.

Appellees brought this suit to challenge this resulting detail of Congress' having conditioned the limited assistance grant on eligibility for Medicaid: a person between the ages of 21 through 64 who resides in a public mental institution is not eligible to receive this small stipend, even though that person meets the other eligibility requirements for SSI benefits, because treatment in a public mental institution for a person in this age bracket is not funded under Medicaid.⁵

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Appellees attack this statutory classification as violative of the equal protection component of the Fifth Amendment's Due Process Clause.⁶ Their challenge, successful in the District Court, is twofold. First they argue that the exclusion of their class of mentally ill (and therefore disabled) persons bears no rational relationship to any legitimate objective of the SSI program. They assert, in fact, that their class was excluded inadvertently because of its political powerlessness. Brief for Appellees 6,32. Second, they insist that because the statute classifies on the basis of mental illness, a factor that

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greatly resembles other characteristics that this Court has found inherently "suspect" as a means of legislative classification, special justification should be required for the congressional decision to exclude appellees.

II

This case has had a somewhat complex procedural history. It initially was instituted in December 1973 as a class action for injunctive and declaratory relief to challenge the federal and Illinois assistance schemes that prevailed prior to the effective date of the SSI program. See Wilson v. Edelman, 542 F.2d 1260, 1263-1266 (CA7 1976). The then-existing state assistance program, for which federal funds were received, excluded from eligibility any person who was residing in a public mental or tuberculosis institution or who was confined in a penal institution. Id., at 1263, n. 2. The plaintiffs later amended their complaint to include a challenge to the SSI exclusion, which by then had come into effect. Id., at 1266. A three-judge court was convened under 28 U.S.C. §§ 2281 and 2282 (1970 ed.) (since repealed by Pub.L. 94-381, §§ 1 and 2, 90 Stat. 1119). The case was consolidated with another that challenged the exclusion from SSI benefits of any pretrial detainee. Relying on Weinberger v. Salfi, 422 U.S. 749, 95 S.Ct. 2457, 45 L.Ed.2d 522 (1975), the court granted the Secretary's motion to dismiss both cases for lack of subject-matter jurisdiction on the ground that the plaintiffs had failed to exhaust the administrative remedies provided for by § 1631(c)(3) of the Act, as amended, 42 U.S.C. § 1383(c)(3). See 542 F.2d, at 1267-1268.⁷

On appeal, appellees abandoned their claims under the prior federal statutes. Id., at 1271. The United States Court of

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Appeals for the Seventh Circuit reversed the dismissal, holding that the Secretary (then Patricia Harris) had waived any requirement of exhaustion by her submission of the case to the District Court for summary disposition.⁸ Id., at 1272. Because the plaintiffs had dropped their request for injunctive relief, the case was remanded to the single-judge District Court. Id., at 1269. That court, on remand, certified the class ⁹ and granted appellees' motion for summary judgment, holding that § 1382(e)'s exclusion of the class members violated the equal protection guarantee of the Due Process Clause of the Fifth Amendment. Sterling v. Harris, 478 F.Supp. 1046 (ND Ill.1979).¹⁰ The District Court reasoned that the statute "creates three classifications: (1) age, and (2) residence in a public, (3) mental health hospital." Id., at 1050. It ruled that Congress' use of the first two factors need be justified only by

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demonstration of their "rational relationship" to "a legitimate state interest." Ibid. Under that standard, these classifications withstood scrutiny. Congress' use, however, of a "mental health" classification was deemed to require a closer examination because "mental health classifications possess...