Independent Living Center v. Shewry

Amicus Brief Filed in the U.S. Court of Appeals for the Ninth Circuit by National Senior Citizens Law Center and National Health Law Program.

SUMMARY OF ARGUMENT

This Court should affirm the district court’s order granting in part, Petitioners-Appellees’ (Petitioners) motion for preliminary injunction. The California Medicaid program, Medi-Cal, has the lowest Medicaid spending per enrollee in the nation and one of the lowest physician reimbursement rates. Due to these low rates, the ratio of primary care physicians to Medi-Cal beneficiaries is already well below the federal minimum standard.1 Numerous studies focused on California, reflect that even before the cuts, few physicians were willing to take Medicaid payments due to the low provider rates. The California Legislature approved a 10 percent cut in provider reimbursement, which absent an injunction would further decrease doctor participation in the program and force some health facilities to close completely, making health care even more inaccessible to low-income California residents. Delayed care and lack of access to care will result in increased morbidity and mortality for California’s most vulnerable citizens, particularly older individuals and the disabled.

The district court was correct in its holding that 42 U.S.C. § 1396a(a) (30)(A) (2008) preempts Cal. Assemb. B. 5, X3 Sess. Ca. (2008), the state statute that cut provider rates. This Court has previously rejected the argument, advanced by Respondents-Appellants (Respondents), that the repeal of the Boren Amendment was "intended ‘to terminate ... judicial oversight’ of reimbursement rates.