Supreme Court Refuses to Shut Courthouse Doors on the Poor

On February 22, 2012, the Supreme Court rejected an attempt to eliminate a critical legal tool for protecting the rights of low-income individuals, including many elderly poor. Douglas v Independent Living Center is a significant victory for court access for those low-income beneficiaries who rely on Medicaid coverage to obtain prescription medications, hospital care, and other medical services.

The case addresses whether people with limited income and resources can sue states that enact laws which conflict with federal Medicaid requirements in the same way that businesses sue states to challenge state consumer protection laws. NSCLC and others had argued that the only issue before the Supreme Court is whether the Supremacy Clause of the Constitution – commonly invoked by businesses challenging state environmental or consumer protection laws – applies to the claims of poor people, including low income older adults, who were unable to obtain medication from pharmacies due to the reimbursement rates being below cost.

In a 5:4 decision, written by Justice Breyer, and joined by Justices Kennedy, Ginsburg, Sotomayor and Kagan, the majority refused to throw the case out of court. The majority instead sent the case back to the Court of Appeals for futher consideration of the impact of the federal government’s recent approval of some of the cuts proposed by the State of California to its Medi-Cal program.

Chief Justice Roberts, joined by Justices Scalia, Thomas and Alito, dissented and would have dismissed the action. The dissent argues that the Supremacy Clause does not permit court access to enforce the Medicaid statute, even though past Court decisions have allowed businesses to do so.

Directing Attorney Rochelle Bobroff provided extensive comments on the merits brief, participated in a meeting to select Supreme Court counsel, and mooted Supreme Court counsel for the oral argument. She also authored blogs for the American Constitutional Society on the case and was quoted in both the New Republic and Politico Pro after the oral arguments were heard.

Read a blog on the Supreme Court decision

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