Markva v. Haveman

317 F.3d 547 (6th Cir. 2003) ; Clearinghouse Number: 54342

Description

Michigan May Not Calculate Medicaid Eligibility and Benefits Differently for Nonparent and Parent Caretakers

Abstract

The Sixth Circuit affirmed that Michigan’s policy and practice of calculating Medicaid eligibility and benefit amounts differently for nonparent relative caretakers and parent caretakers violated the federal Medicaid statute and its implementing regulations. Michigan’s policy allows parent caretakers applying for Medicaid to exclude from countable income an amount allocated for the care of their dependent children, whereas nonparent relatives acting as caretaker and applying for Medicaid may not deduct a similar portion from their income to reflect the financial needs of the children under their care. Thus, to receive Medicaid benefits, nonparent caretakers pay a higher deductible or “spend-down” than parent caretakers. Challenging this policy, plaintiff-appellees, a class of “medically needy” grandparents raising their grandchildren in the absence of the children’s parents, sued defendant-appellant directors of two state Medicaid agencies under 42 U.S.C. § 1983. The district court held that the policy of using different calculation methods violated Medicaid law in various respects. Agreeing, the Sixth Circuit concluded that there was no basis in the relevant statute or regulations to distinguish among individuals in the “medically needy” “caretaker relative” group based on financial responsibility or other criteria and that Michigan’s methodology for determining the Medicaid benefits of nonparent caretaker applicants was more restrictive than the pre–July 1996 methodology used to calculate Aid to Families with Dependent Children benefits for the same group. The court also agreed that defendants’ policy violated the requirement that states provide equal “amounts, duration, and scope” of Medicaid coverage to similarly situated caretaker relatives because the differing calculation methods resulted in nonparent caretakers being burdened with significantly higher spend-down amounts. The Sixth Circuit affirmed the district court’s order permanently enjoining defendants from using a methodology to calculate Medicaid eligibility and benefits, including the monthly spend-down amount, differently for nonparent relative and parent caretakers.

Additional Information

Attorney Information
Plaintiffs represented by: Jackie Doig, Center for Civil Justice, 320 South Washington, 2d Floor, Saginaw, MI 48607 (989.755.3120)
Docket Date
2003-01-27 00:00:00+00:00