Medicaid is the primary source of health insurance for people with low-incomes and other vulnerable populations in the United States today. The program is governed by the federal Medicaid Act, which sets out the basic legal framework that states that elect to participate must follow when administering their programs. When state actions appear to violate the federal law, Medicaid beneficiaries and/or providers historically have sued, seeking to enforce specific provisions of the Medicaid Act, which itself does not speak to the role of the federal courts. Over the years, federal courts have taken a closer look at the legal criteria that private parties, such as beneficiaries and providers, must establish before being permitted to pursue these cases. This issue--whether the parties may maintain a cause of action--has become an important procedural test that must be satisfied before a court will consider the underlying substantive claims in such lawsuits. On January 20, 2015, the United States Supreme Court will hear oral argument in Armstrong v. Exceptional Child Center, a case that has the potential to impact the future ability of private parties to sue states in federal court to enforce the requirements of the Medicaid Act.1 The case raises the issue of whether Medicaid providers can challenge a state law in federal court on the basis that it violates the federal Medicaid Act and therefore is preempted by the Supremacy Clause of the U.S. Constitution. This issue brief examines the major questions raised by the Armstrong case, explains the parties' legal arguments, and considers potential effects of a U.S. Supreme Court decision.
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)