Left Coast Voices

"I would hurl words into the darkness and wait for an echo. If an echo sounded, no matter how faintly, I would send other words to tell, to march, to fight." Richard Wright, American Hunger

Medcaid 2

Following on from yesterday’s post, I am struggling to understand how individuals have been denied the right to sue the state that they pay taxes to. It seems a gross obstruction to personal freedom.However, the Justice Department has backed the State of California agreeing that the individual cannot sue, while also admitting that Federal law clearly states that Medicaid rates be “sufficient to enlist enough providers.” In other words, there should be no discrimination of resources or access to treatment between the beneficiaries of Medicaid and everyone else in their state. Only what happens when that is precisely what is happening?


“California has been accepting more than $20 billion in federal Medicaid funds per year in exchange for its promise, among other things, to ensure that needy patients had access to health care,” Democratic chiefs wrote in their brief, “California has failed to adhere to its obligations.”

What they are fighting for is the right of the patient or the medical providers to challenge in court any violation of federal law. The response of the Justice Department is that federal health officials have “exclusive responsibility” to enforce the standards set and can punish a state by withholding Medicaid resources from any state found wanting.

The question is whether they would. One former federal health official told the Supreme Court that the DHHS was not able to enforce this stating it was “logistically, practically, legally and politically unfeasible.” The reason being that the DHHS does not have either the staff, money or political clout to do this.

The supporters of the right to sue have all been endorsed and supported by the AARP, the American Hospital Association, the American Medical Association, civil rights groups and the U.S. Chamber of Commerce.

“Judicial enforcement is the only viable means to remedy states’ noncompliance with the Medicaid Act,” the A.M.A. said.

True protection can only come in the courts

In the true story behind my novel, The Accidental Activist, the British Government was ultimately found guilty of not protecting the citizen from a multinational corporation. In the US, the struggle is similar, except we are seeking protection from our own elected government and its agencies. The President, I feel, should understand this better than most.

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Alon Shalev is the author of The Accidental Activist (now available on Kindle) and A Gardener’s Tale. He is the Executive Director of the San Francisco Hillel Foundation, a non-profit that provides spiritual and social justice opportunities to Jewish students in the Bay Area. More on Alon Shalev at http://www.alonshalev.com/and on Twitter (#alonshalevsf).

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