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Immel v. Lumpkin

AARP Asks Federal Appeals Court to Allow Medicaid Challenge to be Considered

AARP has filed a brief supporting an applicant denied Medicaid coverage. The state argues that a federal court has no jurisdiction to hear the dispute, a position which if upheld would eliminate many worthy challenges to eligibility denials filed by the nation's most at-risk people.

Mary Immel's application for Medicaid was rejected three times on various grounds by Ohio, and while each time a hearing officer rejected the state's reasons, the state continued to deny her application. Immel then sued in federal court. Immel v. Lumpkin is now before the U.S. Court of Appeals for the Sixth Circuit.

Background

Medicaid is a federal-state partnership that provides health insurance coverage for those with extremely low incomes and specific target populations (people with disabilities, children in foster care and others Congress has determined are particularly at risk). States are not required to have Medicaid programs, but if they elect to participate in the program and thereby receive significant federal funding to provide health care services, states must abide by federal rules governing services provided and governing eligibility determination.

At issue in the Immel case is the standard of review a federal court applies in considering a state's denial of eligibility. There is a longstanding federal doctrine that severely limits federal courts from reviewing a state court's decision about its own state's laws, and Ohio has invoked that doctrine in seeking to escape federal court review.

AARP's Brief

But as Mary Immel argues, and as AARP argues in its "friend of the court" brief filed by AARP Foundation Litigation attorneys in conjunction with the National Senior Citizens Law Center and the National Health Law Program, the federal doctrine described above has never been extended to Medicaid, a state hearing officer is not a state court and, therefore, the reliance on a state court determination is inapplicable here.

The issue is important because many people denied Medicaid eligibility bring their disputes in federal court, relying on the fact that the law is a federal-state partnership and that a federal court is the appropriate place to get a fair and impartial hearing involving the state's compliance with that law. If the Sixth Circuit were to close this avenue of redress, it would sharply tilt the playing field against applicants denied eligibility, limiting access to quality health services for the nation's most low-income and at-risk populations.


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