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Lovell v. Chandler
No. 98-16545, 98-16548, 99-15928, 99-15930 (9th Cir. Sept. 5, 2002) ; Clearinghouse Number: 54886
Description
Blind and Disabled Persons Who Were Categorically Excluded from Coverage Under Hawaiian Medical Assistance Program Are Entitled to Compensatory Damages
Abstract
The Ninth Circuit has affirmed the district court’s judgment
that defendant state’s exclusion of otherwise-qualified
persons with disabilities from a state health insurance program
violated the Americans with Disabilities Act (ADA). In 1994, the
State of Hawaii launched a new program, QUEST, to begin
transforming its fee-for-service Medicaid program into a more
cost-effective health maintenance organization (HMO)-based plan.
Recipients of general assistance and Aid to Families with Dependent
Children, as well as participants under the State Health Insurance
Program (SHIP), were eligible to receive benefits under QUEST if
their income was no more than 300 percent of the federal poverty
level, unless they were aged, blind, or disabled. As a result,
aged, blind, or disabled persons who met the Medicaid income and
asset tests retained their benefits under the old fee-for-service
program, but several hundred blind and disabled members of the SHIP
population were denied any coverage under QUEST. Plaintiffs claimed
that the state’s categorical exclusion of persons with
disabilities from the QUEST program violated Title II of the ADA
and section 504 of the Rehabilitation Act. The district court
granted plaintiffs’ motion for partial summary judgment,
finding that the state’s action was discriminatory. The court
also partially granted plaintiffs’ motion for class
certification and held that the state was liable for compensatory
damages. The state appealed. The court of appeals held that the
Rehabilitation Act is a valid exercise of Congress’s spending
power and therefore the Eleventh Amendment is not a bar to
individual plaintiffs’ section 504 claims against the state.
The court noted that Congress has a strong interest in ensuring
that federal funds are not used in a discriminatory manner and in
holding states responsible when they violate funding conditions.
The court also held that plaintiffs had established a prima facie
case of violations of both Title II of the ADA and section 504. The
court rejected the state’s argument that plaintiffs were not
denied meaningful access to public benefits because the
fee-for-service program continued to be available after QUEST was
implemented. Finally, the court held that, because the state acted
with deliberate indifference and therefore engaged in intentional
discrimination, plaintiffs are entitled to compensatory damages.
