United States First Circuit

In this case, the Maine Department of Health and Human Services (MDHHS) proposed an amendment in which it sought to drop Medicaid coverage for 19 and 20-year old children whose families met low-income requirements. The federal Department of Health and Human Services (DHHS) disapproved of the amendment, stating that it plainly violates a maintenance-of-effort (MOE) provision of the Affordable Care Act, 42 U.S.C. section 1396a(gg). Petition for review is denied, where: 1) the MOE provision as applied here does not create a new program and falls within Congress's express reservation of power to "alter" or "amend" the terms of the Medicaid statute in its coverage of previously covered groups; 2) Maine was on notice that an incremental alteration of Medicaid might change the conditions on participation in the Medicaid program in the way that the MOE provision has; and 3) any disparate treatment caused by the MOE provision is sufficiently related to the problem that the statute was designed to address.

Appellate Information

• Decided 11/17/2014
• Published 11/17/2014

Judges

• Lynch

Court

• United States First Circuit

Counsel