D.Conn.: state Medicaid law preempted by federal statute

The District Court for Connecticut granted a motion for a preliminary injunction, finding that the plaintiff had established a likelihood of success on the merits of his claim that the federal Medicaid law preempts a state statue regarding spousal support rights.    Fortmann ex rel. Rubino v. Starkowski, No. 3:10cv1562 (JBA), 2011 WL 4502906 (D. Conn., Sep. 28, 2011).  Judge Janet Arterton, nominated by President Bill Clinton, wrote the opinion of the court.

The magistrate’s opinion explains the facts of the case.  Fortmann v. Starkowski, 3:10 CV 1562 (JBA) 2011 WL 4502939 (D.Con. Magistrate, Jan. 18, 2011).  Bernhard Fortmann was denied Medicaid benefits in 2006 and again in 2009. The second application was denied on the grounds that Fortmann’s wife had resources in excess of the statutory limit for receiving Medicaid benefits. Fortmann argued that he had assigned his right to financial support from his wife to the Connecticut Department of Social Services (DSS), and therefore her resources should not be counted against him in his application for benefits.   Fortmann sought declarative relief and an injunction against DSS on the basis that DSS had violated federal law by refusing to consider the assignment of his right to support in its resources calculation.  The Magistrate recommended partially granting an injunction against DSS.  Both parties filed objections.

First the district court rejected the defendant’s argument that the court lacked subject matter jurisdiction.  The court agreed with the defendant that a plaintiff must file a well-pleaded complaint based on a federal cause of action or a substantial question of federal law.   A claim arising under the Medicaid Act, the court held, satisfied those requirements.

The court next rejected the defendant’s contention that the Eleventh Amendment of the Constitution barred the plaintiff’s claims.  The court dismissed the defendant’s argument based on Pennhurst State School & Hosp. v. Halderman, 465 U.S. 89 (1984) that the court could not enjoin state officials for violations of state law.  The issue here, the court emphasized, was a violation of federal law, and Pennhurst’s rule did not apply.  The court also dismissed the defendant’s claim based on Edelman v. Jordan, 415 U.S. 651 (1974) that the plaintiff’s requested injunction would amount to retrospective relief and thereby violate the Eleventh Amendment.  Although the plaintiff’s requested injunction would include an order for back payments, those back payments would be ancillary to prospective relief and therefore would not constitute a retrospective damages award.

The court then turned to the merits of the plaintiff’s claim for injunctive relief and the question of whether he was likely to succeed on the merits of his claims.

The court held that the state’s statute regarding spousal support rights conflicted with federal Medicaid statute 42 U.S.C. § 1396k.  The federal statute requires individuals to assign their support rights to states, while the state law limited the assignment of support rights.  The plaintiff argued that a person could not comply with the state and federal statutes at the same time.  The court agreed and held that the state statute was invalid under the doctrine of conflict preemption and the Supremacy Clause of the Federal Constitution.  Because the state law was preempted, the court ruled that the plaintiff was likely to succeed on the merits of his claim.

In granting the preliminary injunction, the court instructed that the state could not deny Medicaid eligibility based on the wife’s resources.  But limiting its relief to “preserving the status quo,” the court set an expedited schedule for summary judgment.

–Nate Vogel, University of Pennsylvania Law School, class of 2011

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