Case: Young v. Azar

1:19-cv-03526 | U.S. District Court for the District of Columbia

Filed Date: Nov. 22, 2019

Case Ongoing

Clearinghouse coding complete

Case Summary

This case is one of several federal cases challenging the Trump Administration’s ongoing attempts to reduce Medicaid eligibility under the Affordable Care Act (ACA). The case arose from federal and state efforts to limit the ACA’s Medicaid expansion. Medicaid, established under Title XIX of the Social Security Act, requires states to cover all individuals of a mandatory covered population group and prohibits states from imposing additional eligibility requirements. However, Section 1115 of t…

This case is one of several federal cases challenging the Trump Administration’s ongoing attempts to reduce Medicaid eligibility under the Affordable Care Act (ACA). The case arose from federal and state efforts to limit the ACA’s Medicaid expansion. Medicaid, established under Title XIX of the Social Security Act, requires states to cover all individuals of a mandatory covered population group and prohibits states from imposing additional eligibility requirements. However, Section 1115 of the Social Security Act allows DHHS to waive certain federal Medicaid requirements when necessary to allow a state to carry out an experimental project that is likely to promote the Act’s objectives.

In 2010, the ACA expanded Medicaid coverage to include adults with household incomes less than 133% of the federal poverty level (FPL). Michigan passed legislation authorizing the Medicaid expansion but sought a waiver under Section 1115 to require new enrollees to pay premiums and copayments that could be reduced by the individual’s engagement in certain “healthy behaviors.” For enrollees with incomes above the FPL, the monthly premium was set at two percent of the individual’s income. DHHS granted the waiver application, effective through December 31, 2018, but specified that no individual may lose or be denied Medicaid eligibility for failure to pay premiums or copayments.

In January 2018, DHHS issued a letter to state Medicaid directors announcing its intention to approve Medicaid waiver applications containing work requirements. This action was consistent with President Trump's January 20, 2017 executive order instructing federal agencies to scale back the ACA “[t]o the maximum extent permitted by law."

In response, Michigan submitted a Section 1115 waiver application that would add mandatory work requirements. The work requirements consisted of 80 hours of specified work or work-related activities per month and mandatory monthly reporting of work activities, with the loss of coverage for enrollees who do not report the required hours for three months in a 12-month period. The application also included mandatory healthy behaviors and heightened, mandatory premiums for enrollees with incomes above the FPL who received coverage for 48 cumulative months. Failure to pay a premium within 60 days after the invoice date would result in termination of coverage. Enrollees in the same subgroup also had to complete a health risk assessment or specified healthy behaviors in the 12 months before their annual redetermination to remain eligible.

DHHS approved these three HMP waivers, effective January 1, 2019 through December 31, 2023, and granted Michigan permission to implement the measures starting January 1, 2020. The work requirements went into effect on January 1, 2020. The state deferred the implementation of the healthy behavior requirements and new premium requirements until October 1, 2020.

The plaintiffs, all members of Michigan’s Medicaid program, filed this class-action lawsuit on November 22, 2019 in the U.S. District Court for the District of Columbia against the U.S. Department of Health and Human Services (DHHS). The plaintiffs challenged amendments to the Healthy Michigan Plan (HMP), including work requirements that would result in the loss of health coverage for 61,000 to 183,000 individuals. Represented by the National Health Law Program, the Center for Civil Justice, and the Michigan Poverty Law Program, the plaintiffs requested an injunction against the defendants’ implementation of Michigan’s amended HMP eligibility requirements and declaratory relief.

Specifically, the plaintiffs argued that the defendants failed to undergo the required rule-making process in issuing a new policy on Medicaid waivers and acted outside the scope of their waiver authority under Section 1115 of the Social Security Act in approving Michigan’s application that imposed additional Medicaid eligibility requirements. According to the plaintiffs, these actions violated the Administrative Procedure Act (5 U.S.C. § 551 et seq.), the Social Security Act, and the Take Care Clause in Article II, Section 3 of the U.S. Constitution. The plaintiffs sued on their behalf and on behalf of all Michigan residents enrolled in the HMP on or after January 1, 2019.

On February 19, 2020 the Michigan Department of Health and Human Services (MDHHS) filed an unopposed motion to intervene, which was granted the next day. On February 25, 2020, MDHHS filed a motion for partial summary judgment solely on the issue of whether the federal approval of the work and community-engagement requirements in the HMP section 1115 demonstration project was lawful. In light of the D.C. Circuit Court’s decision in Gresham v. Azar, striking down the work requirements of the Arkansas Medicaid program under the Section 115 waiver, Judge Boasberg granted MDHHS’s motion for partial summary judgment. The December 21, 2018 approval of the work and community engagement requirements in the Healthy Michigan Plan Amended Demonstration Extension Application by the defendant, Secretary Azar, was vacated. Michigan could not enforce the Medicaid work or community engagement requirements that went into effect on January 1, 2020.

On April 2, 2020, MDHHS filed a motion to stay in light of the COVID-19 pandemic. The same day, the court granted the motion and the case is stayed until the earlier of 1) the end of the COVID-19 public health emergency, or 2) 45 days before the date Michigan begins to implement the premiums that are conditions of continued Medicaid eligibility or the healthy behavior requirements that are conditions of continued Medicaid eligibility.

As of June 2020, the Medicaid work and community engagement requirements cannot be enforced. The plaintiffs challenged the payment of premium and cost sharing, community engagement, and healthy behavior components of the HMP. The plaintiffs did not specifically challenge the rest of the waiver, but the complaint asked the court to permanently enjoin the entire HMP. When the case resumes, the court will need to decide on the appropriate remedy, whether to disband the entire HMP, or to only vacate some or all of the specifically challenged portions.

Background

Medicaid beneficiaries in four other states have filed similar suits challenging the Administration's use of Section 1115 waiver authority. See Stewart v. Azar (Kentucky), Gresham v. Azar (Arkansas), Philbrick v. Azar (New Hampshire), and Rose v. Azar (Indiana). In Stewart v. Azar, the court struck down Kentucky's waiver, which included work requirements, on the basis that the agency failed to sufficiently consider the impact of the proposed project on Medicaid coverage. Similarly, in Gresham v. Azar, the court found that the agency failed to adequately consider how the imposition of work requirements in Arkansas's program would lead to loss of coverage for a substantial number of beneficiaries including the needy, a core group under Medicaid.

Summary Authors

Kat Zhao (2/1/2020)

Sabrina Glavota (5/22/2020)

People

For PACER's information on parties and their attorneys, see: https://www.courtlistener.com/docket/16504777/parties/young-v-azar/


Judge(s)

Boasberg, James Emanuel (District of Columbia)

Attorneys(s) for Plaintiff

Bidelman, Kelly L. (Michigan)

Grusin, Sarah (North Carolina)

Jordan, Linda A. (Michigan)

Perkins, Jane (North Carolina)

Ruby, Lisa (Michigan)

Somers, Sarah (North Carolina)

Attorneys(s) for Defendant

Andrapalliyal, Vinita (District of Columbia)

Skurnik, Matthew (District of Columbia)

Other Attorney(s)

Active

Judge(s)

Boasberg, James Emanuel (District of Columbia)

Attorneys(s) for Plaintiff

Bidelman, Kelly L. (Michigan)

Grusin, Sarah (North Carolina)

Jordan, Linda A. (Michigan)

Perkins, Jane (North Carolina)

Ruby, Lisa (Michigan)

Somers, Sarah (North Carolina)

Attorneys(s) for Defendant

Andrapalliyal, Vinita (District of Columbia)

Skurnik, Matthew (District of Columbia)

Other Attorney(s)

Brown, Caroline M. (District of Columbia)

Eyman, Barbara D. A. (District of Columbia)

Harris, Toni L. (Michigan)

Peisch, Philip (District of Columbia)

Documents in the Clearinghouse

Document

Docket [PACER]

April 2, 2020 Docket
1

Complaint

Nov. 22, 2019 Complaint

Docket

See docket on RECAP: https://www.courtlistener.com/docket/16504777/young-v-azar/

Last updated May 11, 2022, 8 p.m.

ECF Number Description Date Link
1

COMPLAINT against All Plaintiffs (Fee Status:Filing Fee Waived) filed by MARIA YAKOVCHIK, KATINA PETROPOULOS, JAMIE ARDEN, ANDREA YOUNG. (Attachments: # 1 Exhibit A, # 2 Civil Cover Sheet, # 3 Summons, # 4 Summons, # 5 Summons, # 6 Summons, # 7 Summons, # 8 Summons)(Perkins, Jane) (Entered: 11/22/2019)

1 Exhibit A

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2 Civil Cover Sheet

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3 Summons

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4 Summons

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5 Summons

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6 Summons

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7 Summons

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8 Summons

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Nov. 22, 2019 RECAP

Payment of Fee

Nov. 22, 2019 PACER

Payment of Fee - Complaint

Nov. 22, 2019 PACER
2

NOTICE OF RELATED CASE by All Plaintiffs. Case related to Case No. 18-cv-00152; 18-cv-01900; 19-cv-00773; 19-cv-02848. (Perkins, Jane) (Entered: 11/22/2019)

Nov. 22, 2019 PACER

Payment for 1 Complaint,. ($400; Receipt number ADCDC-6587099). (Perkins, Jane)

Nov. 22, 2019 PACER

Case Assigned/Reassigned

Nov. 25, 2019 PACER

Case Assigned to Judge James E. Boasberg. (zsb)

Nov. 25, 2019 PACER
3

SUMMONS (6) Issued Electronically as to ALEX M. AZAR, II, CENTERS FOR MEDICARE AND MEDICAID SERVICES, UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, SEEMA VERMA, U.S. Attorney and U.S. Attorney General (Attachment: # 1 Notice and Consent)(zsb) (Entered: 11/25/2019)

1 Notice and Consent

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Nov. 25, 2019 RECAP
4

RETURN OF SERVICE/AFFIDAVIT of Summons and Complaint Executed. ALEX M. AZAR, II served on 12/2/2019 (Perkins, Jane) (Entered: 12/02/2019)

Dec. 2, 2019 PACER
5

RETURN OF SERVICE/AFFIDAVIT of Summons and Complaint Executed. SEEMA VERMA served on 11/29/2019 (Perkins, Jane) (Entered: 12/02/2019)

Dec. 2, 2019 PACER
6

RETURN OF SERVICE/AFFIDAVIT of Summons and Complaint Executed. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES served on 12/2/2019 (Perkins, Jane) (Entered: 12/02/2019)

Dec. 2, 2019 PACER
7

RETURN OF SERVICE/AFFIDAVIT of Summons and Complaint Executed. CENTERS FOR MEDICARE AND MEDICAID SERVICES served on 11/29/2019 (Perkins, Jane) (Entered: 12/02/2019)

Dec. 2, 2019 PACER
8

RETURN OF SERVICE/AFFIDAVIT of Summons and Complaint Executed on United States Attorney General. Date of Service Upon United States Attorney General 12/2/2019. (Perkins, Jane) (Entered: 12/02/2019)

Dec. 2, 2019 PACER
9

RETURN OF SERVICE/AFFIDAVIT of Summons and Complaint Executed as to the United States Attorney. Date of Service Upon United States Attorney on 12/2/2019. Answer due for ALL FEDERAL DEFENDANTS by 1/31/2020. (Perkins, Jane) (Entered: 12/02/2019)

Dec. 2, 2019 PACER
10

Joint MOTION for Briefing Schedule by JAMIE ARDEN, KATINA PETROPOULOS, MARIA YAKOVCHIK, ANDREA YOUNG (Perkins, Jane) (Entered: 12/30/2019)

Dec. 30, 2019 PACER
11

NOTICE of Appearance by Vinita B. Andrapalliyal on behalf of All Defendants (Andrapalliyal, Vinita) (Entered: 01/02/2020)

Jan. 2, 2020 PACER

.Order

Jan. 2, 2020 PACER

Order

Jan. 2, 2020 PACER

MINUTE ORDER: The Court ORDERS that the parties shall appear for a Status Conference on January 9, 2020 at 11:00 a.m. in Courtroom 25. So ORDERED by Judge James E. Boasberg on 1/2/2020. (lcjeb1)

Jan. 2, 2020 PACER

Set/Reset Hearings

Jan. 2, 2020 PACER
12

NOTICE of Appearance by Matthew Charles Skurnik on behalf of ALEX M. AZAR, II, CENTERS FOR MEDICARE AND MEDICAID SERVICES, UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, SEEMA VERMA (Skurnik, Matthew) (Entered: 01/02/2020)

Jan. 2, 2020 PACER

Set/Reset Hearings: Status Conference set for 1/9/2020 at 11:00 AM in Courtroom 25A before Judge James E. Boasberg. (znbn)

Jan. 2, 2020 PACER

Set/Reset Hearings

Jan. 6, 2020 PACER

~Util - Set/Reset Deadlines

Jan. 9, 2020 PACER

Status Conference

Jan. 9, 2020 PACER

Minute Entry for proceedings held before Judge James E. Boasberg: Status Conference held on 1/9/2020. The Court ORDERS the parties to submit a Joint Proposed Order by 1/14/2020. (Court Reporter Cathryn Jones) (nbn)

Jan. 9, 2020 PACER
13

PROPOSED BRIEFING SCHEDULE by JAMIE ARDEN, KATINA PETROPOULOS, MARIA YAKOVCHIK, ANDREA YOUNG. (Perkins, Jane) (Entered: 01/14/2020)

Jan. 14, 2020 PACER

Order on Motion for Briefing Schedule

Jan. 14, 2020 PACER
14

ORDER on the Briefing Schedule. Signed by Judge James E. Boasberg on 1/14/2020. (lcjeb1) (Entered: 01/14/2020)

Jan. 14, 2020 RECAP

Set/Reset Deadlines

Jan. 14, 2020 PACER

MINUTE ORDER: Given the Court's 14 Order on a briefing schedule, it ORDERS that Plaintiffs' 10 Motion is DENIED as moot. So ORDERED by Judge James E. Boasberg on 1/14/2020. (lcjeb1)

Jan. 14, 2020 PACER

Set/Reset Deadlines: Administrative Record due by 1/24/2020. Notice due by 1/28/2020. Brief due by 2/25/2020. Responses due by 3/17/2020. Replies due by 3/31/2020. (nbn)

Jan. 14, 2020 PACER
15

NOTICE of Filing of Certified Index of Administrative Record by ALEX M. AZAR, II, CENTERS FOR MEDICARE AND MEDICAID SERVICES, UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, SEEMA VERMA (Attachments: # 1 Certified Index)(Andrapalliyal, Vinita) (Entered: 01/24/2020)

Jan. 24, 2020 PACER
16

NOTICE by ALEX M. AZAR, II, CENTERS FOR MEDICARE AND MEDICAID SERVICES, UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, SEEMA VERMA re 14 Order (Andrapalliyal, Vinita) (Entered: 01/28/2020)

Jan. 28, 2020 PACER
17

NOTICE of Appearance by Toni L. Harris on behalf of MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES (Harris, Toni) (Entered: 02/19/2020)

Feb. 19, 2020 PACER
18

NOTICE of Appearance by Caroline Montrose Brown on behalf of MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES (Brown, Caroline) (Entered: 02/19/2020)

Feb. 19, 2020 PACER
19

NOTICE of Appearance by Philip J. Peisch on behalf of MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES (Peisch, Philip) (Entered: 02/19/2020)

Feb. 19, 2020 PACER
20

Unopposed MOTION to Intervene & Incorporated Memorandum of Points & Authorities by MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES (Harris, Toni) (Entered: 02/19/2020)

Feb. 19, 2020 PACER

Order on Motion to Intervene

Feb. 20, 2020 PACER

MINUTE ORDER: The Court ORDERS that Intervenor's 20 Motion to Intervene is GRANTED, and it shall file briefs on the same schedule as the other parties to the case. So ORDERED by Judge James E. Boasberg on 2/20/2020. (lcjeb1)

Feb. 20, 2020 PACER

Notice of QC

Feb. 20, 2020 PACER

NOTICE OF ERROR re 17 Notice of Appearance; emailed to harrist19@michigan.gov, cc'd 12 associated attorneys -- The PDF file you docketed contained errors: 1. Please update your address in PACER. (ztth, )

Feb. 20, 2020 PACER
21

Unopposed MOTION for Extension of Time to File Briefs by ALEX M. AZAR, II, CENTERS FOR MEDICARE AND MEDICAID SERVICES, UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, SEEMA VERMA (Skurnik, Matthew) (Entered: 02/20/2020)

Feb. 20, 2020 PACER

Order on Motion for Extension of Time to

Feb. 21, 2020 PACER

MINUTE ORDER: The Court GRANTS the Federal Defendants' 21 Motion for Extension of Time and ORDERS that: 1) Federal Defendants shall file their opening brief by March 3, 2020; 2) Plaintiffs shall file any response by March 24, 2020; and 3) Federal Defendants shall file any reply by April 7, 2020. So ORDERED by Judge James E. Boasberg on 2/21/2020. (lcjeb1)

Feb. 21, 2020 PACER

Set/Reset Deadlines

Feb. 21, 2020 PACER

Set/Reset Deadlines: Brief due by 3/3/2020. Responses due by 3/24/2020. Replies due by 4/7/2020. (nbn)

Feb. 21, 2020 PACER
22

MOTION for Partial Summary Judgment by MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES (Attachments: # 1 Exhibit A, # 2 Text of Proposed Order)(Harris, Toni) (Entered: 02/25/2020)

1 Exhibit A

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2 Text of Proposed Order

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Feb. 25, 2020 PACER
23

MEMORANDUM by MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES. (Attachments: # 1 Exhibit 1)(Harris, Toni) (Entered: 03/03/2020)

March 3, 2020 PACER
24

MEMORANDUM by ALEX M. AZAR, II, CENTERS FOR MEDICARE AND MEDICAID SERVICES, UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, SEEMA VERMA. (Skurnik, Matthew) (Entered: 03/03/2020)

March 3, 2020 RECAP

.Order

March 4, 2020 PACER

Order

March 4, 2020 PACER

MINUTE ORDER: In light of the D.C. Circuit's recent decision in Gresham v. Azar, the Court ORDERS that: 1) Intervenor's 22 Motion for Partial Summary Judgment is GRANTED; 2) The Secretary's December 21, 2018, approval of the work and community-engagement requirements in the Healthy Michigan Plan Amended Demonstration Extension Application is VACATED; and 3) Once briefing is complete, the Court shall determine the validity of the remainder of the approval and all remedies. So ORDERED by Judge James E. Boasberg on 3/4/2020. (lcjeb1)

March 4, 2020 PACER
25

MOTION for Leave to File Amicus Curiae Brief by MICHIGAN ASSOCIATION OF HEALTH PLANS (Eyman, Barbara) (Entered: 03/16/2020)

March 16, 2020 PACER

Order on Motion for Leave to File

March 16, 2020 PACER

MINUTE ORDER: The Court GRANTS The Michigan Association of Health Plans' 25 Motion for Leave to File an Amicus Brief and ORDERS that it shall file the Amicus Brief by March 19, 2020. So ORDERED by Judge James E. Boasberg on 3/16/2020. (lcjeb1)

March 16, 2020 PACER

Set/Reset Deadlines: Amicus Brief due by 3/19/2020. (znbn)

March 16, 2020 PACER

Set/Reset Deadlines

March 17, 2020 PACER
26

Amicus Brief by MICHIGAN ASSOCIATION OF HEALTH PLANS. (Attachments: # 1 Exhibit Exhibit A)(Eyman, Barbara); Modified text and event on 3/20/2020 (ztth). (Entered: 03/19/2020)

March 19, 2020 PACER
27

RESPONSE re 24 Memorandum, 23 Memorandum, 26 Memorandum filed by JAMIE ARDEN, KATINA PETROPOULOS, MARIA YAKOVCHIK, ANDREA YOUNG. (Perkins, Jane) (Entered: 03/24/2020)

March 24, 2020 PACER
28

MOTION to Stay by MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES (Attachments: # 1 Text of Proposed Order)(Harris, Toni) (Entered: 04/02/2020)

April 2, 2020 PACER

Order on Motion to Stay

April 2, 2020 PACER

MINUTE ORDER: The Court GRANTS Intervenor Michigan Department of Health and Human Services' 28 Motion to Stay. The Court further ORDERS that the case is STAYED until the earlier of (1) the end of the COVID-19 public health emergency declared by Defendant Azar under Section 319 of the Public Health Service Act; or (2) 45 days before the date when Michigan begins to implement the premiums that are conditions of continued Medicaid eligibility or the healthy behavior requirements that are conditions of continued Medicaid eligibility. So ORDERED by Judge James E. Boasberg on 4/2/2020. (lcjeb1)

April 2, 2020 PACER

Case Stayed until the earlier of (1) the end of the COVID-19 public health emergency declared by Defendant Azar under Section 319 of the Public Health Service Act; or (2) 45 days before the date when Michigan begins to implement the premiums that are conditions of continued Medicaid eligibility or the healthy behavior requirements that are conditions of continued Medicaid eligibility. (nbn)

April 2, 2020 PACER

Case Stayed

April 3, 2020 PACER
29

Notice of Appearance

July 15, 2021 PACER

State / Territory: District of Columbia

Case Type(s):

Public Benefits/Government Services

Key Dates

Filing Date: Nov. 22, 2019

Case Ongoing: Yes

Plaintiffs

Plaintiff Description:

Michigan Medicaid enrollees and applicants

Plaintiff Type(s):

Private Plaintiff

Public Interest Lawyer: Yes

Filed Pro Se: No

Class Action Sought: Yes

Class Action Outcome: Pending

Defendants

U.S. Department of Health and Human Services, Federal

Centers for Medicare and Medicaid Services, Federal

Defendant Type(s):

Hospital/Health Department

Case Details

Causes of Action:

Administrative Procedure Act, 5 U.S.C. §§ 551 et seq.

Declaratory Judgment Act, 28 U.S.C. § 2201

Medicaid, 42 U.S.C §1396 (Title XIX of the Social Security Act)

Ex parte Young (federal or state officials)

Availably Documents:

Trial Court Docket

Complaint (any)

Outcome

Prevailing Party: Plaintiff

Nature of Relief:

Declaratory Judgment

Source of Relief:

Litigation

Issues

General:

Government Services

Payment for care

Public assistance grants

Public benefits (includes, e.g., in-state tuition, govt. jobs)

Benefit Source:

Medicaid