NOTE: The Equal Access Illusion: A Growing Majority of Federal Courts Erroneously Foreclose Private Enforcement of 1396a(a)(30) of the Medicaid Act Using 42 U.S.C. 1983 Skip over navigation
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Copyright (c) 2008 University of Memphis Law Review
University of Memphis Law Review

NOTE: The Equal Access Illusion: A Growing Majority of Federal Courts Erroneously Foreclose Private Enforcement of 1396a(a)(30) of the Medicaid Act Using 42 U.S.C. 1983

Spring, 2008

University of Memphis Law Review

38 U. Mem. L. Rev. 697

Author

Andrew R. Gardella *

Excerpt



I. Introduction

Medicaid is a social welfare program that Congress established under the Medicaid Act, which is Title XIX of the Social Security Act of 1965. 1 Like most grant-in-aid programs, 2 Congress enacted the Medicaid Act pursuant to its spending powers, which are authorized under the United States Constitution (the "Constitution"). 3 While states are not required to participate in Medicaid, once a state enrolls in the program it must agree to provide federally prescribed services. 4 If a state fails to comply with the requirements of the Medicaid Act, the federal government has an administrative remedy available, though it is rarely used and is generally considered to be ineffective. 5 Alternatively, private citizens can institute action in an attempt to force a state to comply with the conditions of the Medicaid Act, which constitutes the only effective remedy. 6

With respect to federal remedies, most grant-in-aid programs, including the Medicaid Act, vest the federal government with the power to withdraw funding from states that fail to meet their obligations. 7 While federal agencies that operate grant-in-aid programs possess this authority, they "rarely challenge many nonconforming provisions in state plans . . . . so cutoff of funds is rarely, if ever, invoked." 8 Accordingly, intended beneficiaries of grant-in-aid programs are not adequately protected by federal remedies. 9

On the other hand, private citizens can sue state actors who violate rights secured by the Constitution or federal laws by using 42 U.S.C. 1983, ...
 
 
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