Becerra v. Empire Health Foundation (20-1312)
argument 20-1312Becerra v. Empire Health Foundation
Supreme Court of the United States
1h 9m
8 speakers
8 chapters
transcribed 7 days ago
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What is the central dispute over the meaning of “entitled” versus “eligible” in the Becerra v. Empire Health Foundation case?
We'll hear argument this morning in case twenty thirteen twelve Basera versus Empire Health Fund. Mr.
Bond. Mr Chief Justice, and may it please the court. The Medicare fraction directs HHS to count patient days of patients who, for such days, were entitled to benefits under Part A of Medicare. The question here is which patients are entitled to Part A benefits? Section four hundred twenty six states that every individual who satisfies certain requirements shall be eligible or shall shall be entitled to Part A benefits. And that provision and others make clear that the entitlement is not absolute but subject to conditions, and it is not negated merely because Medicare does not pay for particular units of care. That is the best reading of the statute's text, context, and its population focused design, and at a minimum a reasonable reading that deserves deference.
The Court of Appeals and respondents' contrary reading rests on two inferences based on other language The Court of Appeals inferred from Congress's references to persons eligible for Medicaid that in the Medicare fraction Congress must have meant entitled to Part A to mean something different than it means throughout the statute. But Congress's use of entitled and eligible is fully explained by its usage of those terms in the underlying Medicare and Medicaid programs, governed by separate statutory frameworks. Congress simply took those terms as it found them. Respondent contends that the agency's approach to SSI benefits conflicts with its position here. That is not correct, as the agency explained in the 2010 regulation and as the Sixth Circuit explained in Metro Hospital.
But even if there were a conflict, the solution is not to skew the meaning of entitled to benefits under Part A. The Court should give that phrase the meaning that Congress did in the statute and reserve the SSI benefits issue for a future case. I welcome the court's questions.
Mr. Bond, before we get bogged down in this uh indecipherable language, Um What does um what's the difference between uh entitled to and eligible for. So
in the context of these programs.
No, no, no. just an ordinary meaning.
So in ordinary language I think entitled Refers to having a right to something, but that something may itself be subject to conditions. It does not signify an absolute right. The district court at Petition Appendix 42A pointed to dictionary definitions that go in both directions, and I think that's consistent with ordinary usage, as our seasoned ticket holder example explains. Now in ordinary usage, eligible more naturally means that someone qualifies for something, which is one of the definitions of entitlement. In the dictionaries the district court identified. But whatever the ordinary meanings of those terms, I think it's clear how Congress used them in this particular setting. with respect to entitled in Part A.
You know who is entitled from Section four twenty
So how far can we go with that if there's no definition of entitled in the statute, can we redefine it simply by looking at how it is used throughout the statute?
So to be clear, our argument is not how it's used. We think there is what functions as a definition, both of who is entitled and what that entitlement means. Now those provisions are at 426 A and B, which answers the question who is entitled. It says every individual in these categories shall be entitled. And then it says in 426 C1 and 1395 D what that entitlement means. Consists of, and it says that that entitlement is a right to have payment made for certain services, but subject to conditions set forth in the statute. So the statute is telling you that entitlement here does not mean an absolute right. And I think that's clarified further by Section 1395 L, which refers in two places to a person who is entitled to benefits under Part A, but has a
exhausted them, showing that exhaustion and entitlement can coexist, and further distinguishes that person from one who is not entitled to Part A benefits at all.
But Mr. Bond, you are interpreting
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Chapters
8 chapters
1
What is the central dispute over the meaning of “entitled” versus “eligible” in the Becerra v. Empire Health Foundation case?
0:00–9:20
2
How do the parties argue the statutory definition of “entitled” under Medicare Part A and its impact on patient‑day counting?
9:20–17:27
3
What is the role of Chevron deference in the agency’s interpretation of the statute, and how do the Justices challenge it?
17:27–25:13
4
How does the disagreement over “four such days” affect the calculation of the Medicare and Medicaid fractions?
25:13–34:37
5
What are the practical consequences of the agency’s rule for safety‑net hospitals and their DSH payments?
34:37–43:42
6
How does the historical rulemaking process (1983‑2004) shape the current interpretation of the statute?
43:42–53:31
7
Why do the Justices raise the Encino procedural issue, and what does it mean for deference to the agency’s rule?
53:31–1:00:44
8
What is the final outcome of the Court’s analysis regarding the better reading of the statute and its effect on payments?
1:00:44–1:09:17