Westside Mothers v. Haveman
| Decision Date | 15 May 2002 |
| Docket Number | No. 01-1494.,01-1494. |
| Citation | 289 F.3d 852 |
| Parties | WESTSIDE MOTHERS, a Michigan Welfare Rights Organization; Michigan League for Human Services, Inc.; Families On the Move, Inc.; American Academy of Pediatrics; American Academy of Pediatric Dentists; B.K., by her next friend Lois Ann K.; D.J., by her next friend Tangela W.; Dn.J., by her next friend Tangela W.; Dm.J., by his next friend Tangela W.; K.K., by her next friend Vicki K.; K.T., by her next friend Veda T.; J.T., by his next friend Veda T., Plaintiffs-Appellants, v. James K. HAVEMAN, Jr., Director of the State of Michigan Department of Community Health; Robert Smedes, Deputy Director of the Medical Services Administration, Defendants-Appellees, United States of America, Intervenor. |
| Court | U.S. Court of Appeals — Sixth Circuit |
Marilyn T. Mullane (briefed), Michigan Legal Services, Detroit, MI, Lourdes A. Rivera (briefed), National Health Law Program Inc., Los Angeles, CA, Thomas K. Gilhool (argued and briefed), Public Interest Law Center of Philadelphia, Philadelphia, PA, Jennifer R. Clarke (argued and briefed), Kelly L. Darr (briefed), Robin P. Sumner (briefed), Jacob I. Kobrick (briefed), Dechert, Price & Rhoads, Philadelphia, PA, Susan K. McParland (briefed), Michigan Association for Children, Southfield, MI, Martha Jane Perkins (briefed), National Health Law Program, Chapel Jill, NC, for Plaintiffs-Appellants.
Erwin Chemerinsky (briefed), Los Angeles, CA, David T. Goldberg, David T. Goldberg Law Office, New York, NY, Phyllis James (briefed), City of Detroit Law Department, Detroit, MI, James L. Feldesman (briefed), Feldesman, Tucker, Leifer, Fidell & Bank LLP, Washington, DC, Larry S. Gage (briefed), Barbara D.A. Eyman (briefed), Charles Luband (briefed), Aimee N. Wall (briefed), Powell, Goldstein, Frazer & Murphy, Washington, DC, Drew S. Days, III (briefed), Morrison & Foerster, Washington, DC, Fordham E. Huffman (briefed), Chad A. Readler (briefed), Jones, Day, Reavis, & Pogue, Columbus, OH, Timothy P. Heather (briefed), Benjamin, Yocum & Heather, Cincinnati, OH, Richard Clayton Trotter (briefed), Texas Justice Foundation, San Antonio, TX, for Amici Curiae.
Erica Weiss Marsden (argued and briefed), Office of the Attorney General, Social Services Division, Lansing, MI, for Defendants-Appellees.
Mark B. Stern (briefed), Alisa B. Klein (argued and briefed), U.S. Department of Justice, Civil Division, Appellate Section, Washington, DC, for Intervenor.
Patrick W. Beatty (briefed), Rebecca L. Thomas (briefed), Robert C. Maier (briefed), Darrell M. Pierre, Jr. (briefed), Office of the Attorney General of Ohio, Columbus, OH, for Amici Curiae.
Before: MERRITT, BOGGS, and MOORE, Circuit Judges.
This suit filed under 42 U.S.C. § 1983 alleges that the state of Michigan has failed to provide services required by the Medicaid program. Plaintiffs, Westside Mothers, other advocacy and professional organizations, and eight named individuals allege that defendants James Haveman, director of the Michigan Department of Community Health, and Robert Smedes, deputy director of the Michigan Medical Services Administration, did not provide the early and periodic screening, diagnosis, and treatment services mandated by the Medicaid Act and related laws.
The Medicaid program, created in 1965 when Congress added Title XIX to the Social Security Act, provides a federal subsidy to states that choose to reimburse poor individuals for certain medical care. See 42 U.S.C § 1396 et seq. (1994 & Supp 2001) ("Medicaid Act"); Harris v. McRae, 448 U.S. 297, 301, 100 S.Ct. 2671, 65 L.Ed.2d 784 (1980). "Although participation in the program is voluntary, participating states must comply with certain requirements imposed by the Act and regulations promulgated by the Secretary of Health and Human Services." Wilder v. Virginia Hosp. Assoc., 496 U.S. 498, 502, 110 S.Ct. 2510, 110 L.Ed.2d 455 (1990). Like all other states, Michigan participates in the Medicaid program. Since 1997, operating under a waiver from the Health Care Finance Administration, Michigan has provided eligible residents Medicaid services by requiring them to enroll in Health Maintenance Organizations, which provide medical care in exchange for a flat monthly fee per participant. J.A. at 165-71.
The Medicaid Act and related regulations set out a detailed list of services every state program must provide. See 42 U.S.C. § 1396 et seq.; 41 C.F.R. §§ 430 et seq. (2000). The Act allows the Secretary of Health and Human Services to limit or end payments to a state whose Medicaid program does not provide these services. See 42 U.S.C. § 1396c.
At issue here is the federal requirement that participating states provide "early and periodic screening, diagnostic, and treatment services... for individuals who are eligible under the plan and are under the age of 21." Id. § 1396d(a)(4)(B); see also id. § 1396d(r) (defining such services); 41 C.F.R. §§ 441.55-.62 (same). The required services include periodic physical examinations, immunizations, laboratory tests, health education, see 42 U.S.C. § 1396d(r)(1), eye examinations, eyeglasses, see id. § 1396d(r)(2), teeth maintenance, see id. § 1396d(r)(3), diagnosis and treatment of hearing disorders, and hearing aids, see id. § 1396d(r)(4).
In 1999, plaintiffs sued the named defendants under § 1983, which creates a cause of action against any person who under color of state law deprives an individual of "any right, privileges, or immunities secured by the Constitution and laws" of the United States. 42 U.S.C. § 1983. They alleged that the defendants had refused or failed to implement the Medicaid Act, its enabling regulations and its policy requirements, by (1) refusing to provide, and not requiring participating HMOs to provide, the comprehensive examinations required by §§ 1396a(a)(43) and 1396d(r)(1) and 42 C.F.R. § 441.57; (2) not requiring participating HMOs to provide the necessary health care, diagnostic services, and treatment required by § 1396d(r)(5); (3) not effectively informing plaintiffs of the existence of the screening and treatment services, as required by § 1396a(a)(43); (4) failing to provide plaintiffs the transportation and scheduling help needed to take advantage of the screening and treatment services, as required by § 1396a(a)(43)(B) and 42 C.F.R. § 441.62; and (5) developing a Medicaid program which lacks the capacity to deliver to eligible children the care required by §§ 1396(a)(8), 1396a(a)(30)(A), and 1396u-2(b)(5). J.A. 38-46.
Defendants moved to dismiss the plaintiffs and for dismissal of the suit. In 1999, the district court granted defendants' motion to dismiss as plaintiffs four organizations.1 It dismissed the Michigan League for Human Services and the Michigan Welfare Rights Organization on the grounds that they lacked constitutional standing, and it dismissed the Michigan chapters of the American Academy of Pediatrics and of the American Academy of Pediatric Dentists on the grounds that they lacked prudential standing. It allowed the remaining organizations and individuals to continue as plaintiffs.
In March 2001 the district court granted defendants' motion to dismiss all remaining claims. See Westside Mothers v. Haveman, 133 F.Supp.2d 549, 553 (E.D.Mich.2001). In a detailed and far-reaching opinion, the district court held that Medicaid was only a contract between a state and the federal government, that spending-power programs such as Medicaid were not supreme law of the land, that the court lacked jurisdiction over the case because Michigan was the "real defendant and therefore possess[ed] sovereign immunity against suit," id., that in this case Ex parte Young was unavailable to circumvent the state's sovereign immunity, and that even if it were available § 1983 does not create a cause of action available to plaintiffs to enforce the provisions in question.
This appeal followed. We reverse on all issues presented.
Much of the district court's decision rests on its initial determinations that the Medicaid program is only a contract between the state and federal government and that laws passed by Congress pursuant to its power under the Spending Clause are not "supreme law of the land." We address these in turn.
1. Whether Medicaid is only a contract.—The district court held that "the Medicaid program is a contract between Michigan and the Federal government." Westside Mothers, 133 F.Supp.2d at 557. The program, it points out, is not mandatory; states choose whether to participate. See 42 U.S.C. § 1396b (). If a state does choose to participate, Congress may then "condition receipt of federal moneys upon compliance by the recipient with federal statutory and administrative directives." Westside Mothers, 133 F.Supp.2d at 556-57 (quoting South Dakota v. Dole, 483 U.S. 203, 206, 107 S.Ct. 2793, 97 L.Ed.2d 171 (1987)).
To characterize precisely the legal relationship formed between a state and the federal government when such a program is implemented, the district court turned to two Supreme Court opinions on related Subjects. In Pennhurst State School and Hosp. v. Halderman ("Pennhurst I"), the Court described the Medicaid program as "much in the nature of a contract," and spoke of the "`contract'" formed between the state and the federal government. 451 U.S. 1, 17, 101 S.Ct. 1531, 67 L.Ed.2d 694 (1981) (quotation marks in original). The relevant passage reads in full:
Unlike legislation enacted under § 5 [of the Fourteenth Amendment], however, legislation enacted pursuant to the spending power is much in the nature of a contract: in return for federal funds, the States agree to comply with federally imposed conditions. The legitimacy of Congress's power to legislate under the spending power thus rests on...
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