Advocate Christ Medical v. Becerra, Sec. of H&HS (23-715)

argument 23-715

Advocate Christ Medical v. Becerra, Sec. of H&HS

Supreme Court of the United States 1h 10m 8 speakers 8 chapters transcribed 1 month ago official recording ↗

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What is the central dispute over the meaning of “entitled to benefits” in the DISH provision?

John G. Roberts 0:00

We will hear argument first this morning in case twenty three seven fifteen, Advocate Christ Medical Centre versus Bacera. Ms. Sherry?

Unknown 0:08

Mr Chief Justice, and may it please the court. The same words in the same sentence should have the same meaning. Today we are talking about the words entitled to benefits in the dish adjustment. Just two terms ago in Empire Health, this court looked at the words entitled to benefits under Medicare Part A and said that it means qualifying for the Medicare Part A program. Entitled to SSI benefits in the same sentence should mean the same thing, qualifying for the SSI program. A person qualifies for the SSI program when she applies and is determined eligible, and that eligibility lasts until it is terminated. The government disagrees because it says that there is no such thing as an SSI program, and the only SSI benefit is a monthly cash payment.

Unknown 0:59

But Congress created what it called a national program. And it created a program of income insurance. This is a program where a person who's low income enough to qualify in the first place is promised a minimum guaranteed income for a calendar year. And in the months where that income is not needed, the cash payment is suspended, nothing is terminated, and other benefits remain available. In the end, this is about DISH and DISH is about ensuring that hospitals are reimbursed for low income patients that are less healthy and that are costlier to treat. And health does not change overnight. The government's interpretation simply does not count that low income population. It does not count the low income Medicaid patient coming out of a nursing home.

Unknown 1:49

It does not count the low income patient waiting for her first check. And the list of those it does not count goes on and on. A dish proxy that does does not measure the low income population is no proxy at all. I welcome the court's questions.

Clarence Thomas 2:06

Uh are there other benefits other than cash under uh uh chap under uh what is it, uh Title sixteen?

Unknown 2:14

There are. There are non cash benefits including Medicaid continuation and you can find that in thirteen eighty two H subsection B and there's also vocational rehabilitation, which you can find in Title sixteen under thirteen uh eighty two D. You know, the government's response to that I think is twofold. It's to say that um non cash is not income, but probably uh more so to say that those aren't benefits under Title Sixteen, but they're both housed in Title Sixteen. They're both triggered by being program eligible under Title Sixteen. Um and especially when it comes to Medicaid continuation, it's referred to as a benefit under thirteen eighty two H, which is in Title Sixteen.

Elena Kagan 2:59

The could you clarify for me um the Medicare, the Medicaid um regulation that the government replies relies on. I it's something it has something to do with if someone's on Medicaid, if they receive more than thirty dollars a month in income. They're no longer eligible for SSI.

Unknown 3:22

Yeah, so so this comes out of the SSI statute and it makes sense when you're thinking of of SSI. So the reasoning behind it is that while you're in a facility where Medicaid is paying for your daily needs, you don't need the full payment. Instead, you'll get this thirty dollar comfort payment, but only if your income is actually under thirty dollars. And for most people, because you get a social security check, that's not gonna be the case. And I think that's one of the most significant problems with the government's approach is it doesn't count any of those individuals as low income for purposes of the Medicare fraction. And it's really significant because we have two different fractions here, right?

Unknown 4:02

One measures low income based on SSI, the other one measures it based on Medicaid eligibility. And so these are people that are by definition Medicaid eligible. And so low income when you think about the Medicaid fraction. Yet because of the way they do the calculation here, they're actually not counted in either fraction.

Elena Kagan 4:26

As I understand it, um when people are placed in nursing homes