Three individuals in Connecticut with serious medical conditions have filed a federal lawsuit against the U.S. Department of Health and Human Services for its interpretation of the Medicaid rules under the Coronavirus Response Act.
All three individuals have been told their full Medicaid coverage was terminated at the end of March 2020 because they no longer meet the eligibility criteria for that coverage.
Without these services, Deborah Carr, one of the plaintiffs, will be unable to dress, transfer from her wheelchair or out of bed, use the toilet, bathe and eat. Similarly, absent these services, Brenda Moore, another plaintiff, will be unable to bathe, dress, transfer, clean herself after using the bathroom and prepare meals, and will be subject to harmful falls, as have happened in the past.
And Mary Ellen Wilson, the third plaintiff, has Multiple Sclerosis and many dental problems. Her dental work is no longer covered and she has had to pay for cabs to get to medical appointments, even though Medicaid has paid for this in the past.
The Department of Health and Human Services did not respond to an emailed request for comment on the lawsuit.
In exchange for receiving billions of dollars of additional federal funding, states are forbidden under the law from involuntarily terminating anyone in the state from Medicaid during the federally-declared COVID-19 public health emergency. But without allowing any opportunity for prior public comment, the Trump administration rule created huge new exceptions to this Congressional requirement out of whole cloth, changing federal policy that had been in place for eight months since the Act was passed in March.
“The requirement to keep people on Medicaid during the ongoing crisis was adopted precisely because Congress recognized the severe threat, not just to individuals but to public health, from ending health insurance to vulnerable, low-income people,” Sheldon Toubman, an attorney at Disability Rights Connecticut, said.
The action asks the court to invalidate the rule and, in the meantime, to restore benefits to persons wrongfully terminated from Medicaid during the public health emergency.
“Overwhelmingly, people want to live in their communities. This is especially true during a pandemic. Any loss of Medicaid benefits disproportionately impacts low-income older adults of color, who are already most at risk of institutionalization and illness due to structural health inequities,” Carol Wong, associate litigation director, Justice in Aging, said.
Despite its stated commitment to health equity, and the ongoing public health emergency, the U.S. Department of Health and Human Services under the Biden Administration has failed to complete the unfinished business of rescinding the prior administration’s “lawless rule,” advocates said. Instead, it prevents older adults, people with disabilities, young mothers, and others from getting the health care they need.
“By stripping Medicaid recipients of benefits they were receiving when the Act was passed, the agency’s interim final rule is in direct conflict with the law, and threatens the health of hundreds of thousands of persons,” Harvey L. Reiter, a partner with the Washington DC office of Stinson LLP, said.
Miriam Heard, senior attorney at the National Health Law Program noted, “Congress enacted a statute that is clear on its face—as worded, the Medicaid Act does not intend for low-income people to be stripped of Medicaid coverage during the COVID pandemic. Of course, that makes sense, given the harsh realities of this public health emergency.”