Appeals court rules against state in Medicaid case
Posted: Friday, May 05, 2006
LINCOLN, Neb. (AP) -- A federal appeals court said Thursday the state of Nebraska was wrong to cut Medicaid payments to some 1,700 single working parents in 2004.
The 8th U.S. Circuit Court of Appeals upheld a decision by U.S. District Judge Laurie Smith-Camp, who ruled that the state wrongly cut so-called "transitional Medicaid benefits" to Kelly Bowlin of Ogallala and others in similar situations.
The Nebraska Appleseed Center for Law in the Public Interest filed the lawsuit on behalf of some 800 single mothers. It accused the state of refusing to give Bowlin and other parents their temporary Medicaid benefits.
Bowlin lost her Medicaid in January 2004 as a result of a 50-cent-per-hour raise from her employer.
According to the class-action lawsuit, Medicaid recipients who get new jobs, raises or begin working enough hours that they exceed income limits must be given "transitional benefits" so they can find an alternative to meet their medical needs.
State Health and Human Services officials declined immediate comment.
Appleseed lawyer Becky Gould hailed the ruling.
"This is going to help a lot of single working parents transition to self-sufficiency by having access to health care through Medicaid," she said.
Nebraska's Medicaid program was altered during a special budget-cutting legislative session in 2002.
There are, on average, about 1,300 working parents in Nebraska who receive Medicaid through the medically needy category, according to the lawsuit.
Bowlin suffers from an unknown medical condition that causes abnormal and continuous menstrual bleeding, according to court records.
The income limit for the medically needy category is $392 per month for a household of two and $492 per month for a household of three.
The case was similar to another filed by Appleseed on behalf of an estimated 10,000 single working parents who were cut from the Medicaid program in 2002.
A federal judge ruled in 2003 in that case that the state had to make payments, which total $18 million a year, to the families while the case was pending.
The state has since settled that lawsuit.
The two mothers who led the 2002 lawsuit -- Teresa Kai of Pender and Stacy Noller of Kearney -- argued that under federal law, they are entitled to continuing Medicaid coverage through the Transitional Medical Assistance program.
The program provides up to a year of additional health care coverage for those terminated from Medicaid.
HHS officials had said they were not required to continue the coverage.
In deciding Bowlin's case, Smith-Camp cited a ruling from the 8th U.S. Circuit Court of Appeals in the 2002 lawsuit. The state had argued that the 8th Circuit ruling in that case was not binding in Bowlin's.
"While I acknowledge that the Eighth Circuit Court did not review a final judgment in Kai, I am compelled to defer to the court's construction of the relevant statutes in this case," Smith-Camp said.
"As the Eighth Circuit Court stated in Kai, `medically needy caretaker relatives are not entitled to Medicaid by reason of any mandatory provision of federal law,"' she said. "But when the state removes these persons from eligibility, it must do so subject to the condition ... that they receive Transitional Medical Assistance."
On The Net:
Nebraska Health and Human Services System: http://www.hhs.state.ne.us/
U.S. District Court: http://www.ned.uscourts.gov/
8th Circuit: http://www.ca8.uscourts.gov
The 8th U.S. Circuit Court of Appeals upheld a decision by U.S. District Judge Laurie Smith-Camp, who ruled that the state wrongly cut so-called "transitional Medicaid benefits" to Kelly Bowlin of Ogallala and others in similar situations.
The Nebraska Appleseed Center for Law in the Public Interest filed the lawsuit on behalf of some 800 single mothers. It accused the state of refusing to give Bowlin and other parents their temporary Medicaid benefits.
Bowlin lost her Medicaid in January 2004 as a result of a 50-cent-per-hour raise from her employer.
According to the class-action lawsuit, Medicaid recipients who get new jobs, raises or begin working enough hours that they exceed income limits must be given "transitional benefits" so they can find an alternative to meet their medical needs.
State Health and Human Services officials declined immediate comment.
Appleseed lawyer Becky Gould hailed the ruling.
"This is going to help a lot of single working parents transition to self-sufficiency by having access to health care through Medicaid," she said.
Nebraska's Medicaid program was altered during a special budget-cutting legislative session in 2002.
There are, on average, about 1,300 working parents in Nebraska who receive Medicaid through the medically needy category, according to the lawsuit.
Bowlin suffers from an unknown medical condition that causes abnormal and continuous menstrual bleeding, according to court records.
The income limit for the medically needy category is $392 per month for a household of two and $492 per month for a household of three.
The case was similar to another filed by Appleseed on behalf of an estimated 10,000 single working parents who were cut from the Medicaid program in 2002.
A federal judge ruled in 2003 in that case that the state had to make payments, which total $18 million a year, to the families while the case was pending.
The state has since settled that lawsuit.
The two mothers who led the 2002 lawsuit -- Teresa Kai of Pender and Stacy Noller of Kearney -- argued that under federal law, they are entitled to continuing Medicaid coverage through the Transitional Medical Assistance program.
The program provides up to a year of additional health care coverage for those terminated from Medicaid.
HHS officials had said they were not required to continue the coverage.
In deciding Bowlin's case, Smith-Camp cited a ruling from the 8th U.S. Circuit Court of Appeals in the 2002 lawsuit. The state had argued that the 8th Circuit ruling in that case was not binding in Bowlin's.
"While I acknowledge that the Eighth Circuit Court did not review a final judgment in Kai, I am compelled to defer to the court's construction of the relevant statutes in this case," Smith-Camp said.
"As the Eighth Circuit Court stated in Kai, `medically needy caretaker relatives are not entitled to Medicaid by reason of any mandatory provision of federal law,"' she said. "But when the state removes these persons from eligibility, it must do so subject to the condition ... that they receive Transitional Medical Assistance."
On The Net:
Nebraska Health and Human Services System: http://www.hhs.state.ne.us/
U.S. District Court: http://www.ned.uscourts.gov/
8th Circuit: http://www.ca8.uscourts.gov
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