The opinion of the court was delivered by: NORMA HOLLOWAY JOHNSON
Plaintiffs bring this action pursuant to 42 U.S.C. § 1983 on behalf of themselves and a putative class of needy children and adults who allegedly have applied or attempted to apply for Medicaid benefits in the District of Columbia. In their amended complaint, they allege that the District of Columbia engages in practices and procedures that violate Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., the accompanying regulations, the Due Process Clause of the Federal Constitution, and D.C. Code §§ 3-205.26 & 3-205.55(a). Presently before the Court are defendants' motion to dismiss and their supplemental motion to dismiss the amended complaint. Upon consideration of the amended complaint, both motions to dismiss, the plaintiffs' oppositions thereto, and defendants' reply,
the Court will grant defendants' first motion to dismiss in part and will deny it in part; the Court will deny the second motion to dismiss in its entirety.
Defendants challenge plaintiffs' "standing" to bring the section 1983 actions for the Title XIX violations. They rely not on the constitutional standing requirements of injury, causation, and redressability, but rather on a prudential limitation articulated in Warth v. Seldin, 422 U.S. 490, 500, 45 L. Ed. 2d 343, 95 S. Ct. 2197 (1975), "whether the constitutional or statutory provision on which the claim rests properly can be understood as granting persons in the plaintiffs' position a right to judicial relief."
Defendants further elaborate on their theory of standing in their allegation that "plaintiffs have failed to carry their burden to show the existence of an express or implied enforceable private right accruing to themselves and members of the putative classes under the subject provisions of Title XIX." Defs.' Reply at 11. Standing, by this definition, is contingent upon the existence of a private federal right enforceable under section 1983. See Howe v. Ellenbecker, 8 F.3d 1258, 1261 (8th Cir. 1993), cert. denied, 128 L. Ed. 2d 49, 1994 U.S. LEXIS 2522, 114 S. Ct. 1373 (March 28, 1994). With respect to plaintiffs' Title XIX claims, then, the "standing" question collapses into the question of whether section 1983 provides a remedy -- whether plaintiffs have a cause of action with respect to the relevant provisions of Title XIX.
A. Availability of Section 1983 Remedy for Title XIX Violations
The Supreme Court has long held that § 1983 is an available remedy for violations of federal statutes. Maine v. Thiboutot, 448 U.S. 1, 65 L. Ed. 2d 555, 100 S. Ct. 2502 (1980). In Wilder v. Virginia Hospital Assn., 496 U.S. 498, 110 L. Ed. 2d 455, 110 S. Ct. 2510 (1990), the Court upheld such a remedy to allow private hospitals to enforce the "reasonable cost" reimbursement principles of the Boren Amendment to the Medicaid statute. Wilder established a "test," 496 U.S. at 509, to determine whether a federal statute creates a "right" enforceable under § 1983. First, a court must consider whether the statutory "provision was intended to benefit the putative plaintiff." 496 U.S. at 510. Next, the court must determine whether the statute reflects merely an unenforceable "'congressional preference' for a certain kind of conduct rather than an actionable binding obligation on the governmental unit." Id. (citing Pennhurst State School & Hospital v. Halderman, 451 U.S. 1, 19, 67 L. Ed. 2d 694, 101 S. Ct. 1531 (1981)). Finally, a § 1983 remedy is unavailable when the interest the plaintiff asserts is "too vague and amorphous such that it is beyond the competence of the judiciary to enforce." Id. (citations and internal quotation marks omitted).
Defendants have not argued that Medicaid recipients are not intended beneficiaries of Title XIX, nor have they argued that Title XIX obligations are "vague and amorphous" as the Wilder Court apparently understood these terms.
Thus, the question for the Court to resolve on this motion to dismiss is whether the relevant statutory provisions satisfy Wilder's "binding obligation" requirement.
In Suter v. Artist M, 118 L. Ed. 2d 1, 112 S. Ct. 1360 (1992), the Supreme Court precluded private party enforcement of the Adoption Assistance and Child Welfare Act (AACWA) under § 1983. As in this case, the Suter plaintiffs sought to enforce alleged rights created pursuant to the spending power of Congress. The Suter Court did not apply the Wilder criteria, but it did distinguish Wilder by contrasting the alleged "right-creating" statutory and regulatory requirements in both cases. The Court of Appeals for this Circuit has yet to determine the impact of Suter. See LaShawn A. by Moore v. Kelly, 301 U.S. App. D.C. 49, 990 F.2d 1319 (D.C. Cir. 1993), cert. denied, 126 L. Ed. 2d 659, 114 S. Ct. 691 (1994). This Court is not of the opinion that Wilder has been effectively overruled. Accord, e.g, Stowell v. Ives, 976 F.2d 65, 68 (1st Cir. 1992). Rather, the judicial task after Suter is to apply the Wilder criteria with attention to what the federal statute (and implementing regulations) "actually require" the state agency receiving federal funds to do. Suter, 112 S. Ct. at 1368. If Congress leaves enforcement of its requirements "up to the state," Id., then no § 1983 remedy exists. If the congressional mandate imposes more specific or objective obligations on the state, see Wilder 496 U.S. at 514-20, then a private 1983 cause of action exists in the statutory beneficiaries to enforce those obligations. The Court will examine each of the statutory provisions implicated in this case under this standard.
1. Claim I -- Infants of Medicaid-Recipient Mothers
Title 42 U.S.C. § 1396a(e)(4) provides:
A child born to a woman eligible for and receiving medical assistance under a State plan on the date of the child's birth shall be deemed to have applied for medical assistance and to have been found eligible for such assistance under such plan so long as the child is a member of the woman's household and the woman remains (or would remain if pregnant) eligible for such assistance. During the period in which a child is deemed under the preceding sentence to be eligible for medical assistance, the medical assistance eligibility identification number of the mother shall be submitted and paid under such number (unless the State issues a separate identification number for the child before such period expires).
This language unambiguously confers an obligation on participating states (1) to deem newborn infants to have applied for medical assistance as of the date of their birth (2) and to hold such infants eligible as of the date of birth. That statutory language is mandatory in its terms is surely not enough to confer a right enforceable under § 1983. Suter, 112 S. Ct. at 1367. However, the actual effect of such mandatory language is to create a binding obligation on the states themselves to treat infants of eligible mothers in a certain fashion. Unlike in Suter, 112 S. Ct. at 1369, this provision does not obligate states merely to submit a plan with certain features; it directs with specificity the way the states administer Medicaid in particular cases. Moreover, as defendants concede, there is no ambiguity problem. The statutory text is as clear as can be with respect to the timing of the state's obligations.
Defendants' attempt to link this provision with the statutory provision regarding the mother's eligibility ignores the obligation on states that § 1396a(e)(4) unambiguously imposes when a mother is eligible for Medicaid benefits. The Court agrees with the parties that the regulations implementing this provision inject no ambiguity into the congressional mandate. The statute creates a private right enforceable under section 1983.
2. Claim II -- Outstation Enrollment
The relevant statutory provision, 42 U.S.C. § 1396a(55) [first entry], provides that a state plan for medical assistance must:
Provide for receipt and initial processing of [the types of] applications of individuals for medical assistance [relevant to this case] . . . at locations which are other than those used for the receipt and processing of applications for aid . . . and which include ...