Barone v. Department of Human Services

526 A.2d 1055, 107 N.J. 355, 1987 N.J. LEXIS 324
CourtSupreme Court of New Jersey
DecidedJune 23, 1987
StatusPublished
Cited by149 cases

This text of 526 A.2d 1055 (Barone v. Department of Human Services) is published on Counsel Stack Legal Research, covering Supreme Court of New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Barone v. Department of Human Services, 526 A.2d 1055, 107 N.J. 355, 1987 N.J. LEXIS 324 (N.J. 1987).

Opinions

The opinion of the Court was delivered by

GARIBALDI, J.

The New Jersey Pharmaceutical Assistance to the Aged and Disabled Act (Pharmaceutical Assistance Act or PAAD), N.J. S.A. 30:4D-20 to -35, grants benefits to financially-eligible disabled residents under the age of sixty-five who receive Social Security Title II Disability Insurance (SSDI) payments, but denies benefits to those disabled persons under the age of sixty-five who do not receive SSDI benefits. The issue in this appeal is whether this distinction — between disabled persons who receive SSDI benefits and those who do not — violates the equal protection clauses of the United States and New Jersey Constitutions. The Appellate Division upheld the constitutionality of the Act. 210 N.J.Super. 276 (1986). We granted certification, 104 N.J. 461 (1986), and now affirm.

I

The Pharmaceutical Assistance Act was originally enacted in 1975 to supplement the New Jersey Medical Assistance and Health Services Act, N.J.S.A. 30:4D-1 to -19, also known as Medicaid. Medicaid was intended to use federal appropriations to the states to provide medical assistance for the elderly, the disabled, and dependent children in need. Individuals eligible for assistance under Medicaid have their pharmaceutical costs paid through that program.

The Pharmaceutical Assistance Act was “designed to ease the burden of spiraling drug costs for senior citizens [and disabled residents] of modest incomes.” N.J.S.A. 30:4D-25. As originally enacted in 1975, PAAD covered only those citizens over the age of sixty-five who were ineligible for Medicaid benefits because their incomes exceeded Medicaid requirements, but were nonetheless unable to afford prescription [359]*359drugs. Specifically, the program was open to any resident over the age of sixty-five whose annual income was less than $9,000. L. 1975, c. 194, § 2. Later in 1975, benefits were extended to any married resident whose income, combined with that of his or her spouse, was less than $12,000 annually. L. 1975, c. 312, § 1. Initially, the program reimbursed eighty percent of the cost of prescription medicine once the cost exceeded a sliding percentage of the recipient’s income. L. 1975, c. 194, § 3. To simplify administration of the program, this sliding percentage was replaced by a requirement that beneficiaries pay one dollar of the cost of each prescription. L. 1977, c. 268, § 1. The program was not eligible for federal funding. Therefore, the State paid for it from the State’s general revenues.

Participation in the Pharmaceutical Assistance Program increased rapidly. By 1978, there were approximately 270,000 senior citizens enrolled in the program. N.J.S.A. 30:4D-25. In 1978, the Legislature raised the co-payment requirement to two dollars, L. 1978, c. 171, § 2, explaining that “the overwhelming success of this program ... has resulted in costs far greater than those anticipated.” N.J.S.A. 30:4D-25. The Legislature said:

[A]lthough the Legislature is desirous of continuing the program as it currently exists, it recognizes that fiscal constraints and a heightened public awareness of the taxpayer’s burden in this State makes it necessary to increase the share now paid by eligible senior citizens and reduce anticipated increases in the State contributions to the program in the future____
A long-term legislative solution is now necessary which establishes this excellent and salutary program on a-sound fiscal basis at a level within the means of the Treasury, thereby enabling it to continue without further substantial modification.
[7d]

In 1981, the Pharmaceutical Assistance Act became a beneficiary of the Casino Revenue Fund. N.J. Const. 1947 Art. IV, § VII, para. 2D. This added revenue enabled the Legislature to raise the income ceiling for eligibility and to extend benefits for the first time to certain disabled citizens. N.J.S.A. 30:4D-21 was amended to provide:

[360]*360Any single resident of this State who is either disabled pursuant to the Federal Social Security Act (42 U.S.C. section 416(i)) or 65 years of age and over whose annual income is less than $12,000.00, or any married resident whose annual income combined with that of his spouse is less than $15,000, shall be eligible for “Pharmaceutical Assistance to the Aged and Disabled” if he is not otherwise qualified for assistance under the act to which this act is a supplement.
[L. 1981, c. 499, § 1 (emphasis added).]

A person is disabled under 42 U.S.C.A. § 416(i) if he or she (1) is unable to engage in “any substantial gainful activity” because of a physical or mental impairment that will result in death or can be expected to last at least twelve months; or (2) has “central visual acuity of 20/200 or less in the better eye with use of a correcting lense.”

The Department of Human Services (Department) is charged with administering the Act. The Commissioner of Human Services (Commissioner) is authorized to, “by regulation[,] establish a system of payments or reimbursement and a system of determining eligibility.” N.J.S.A. 30:4D-24. To implement N.J.S.A. 30.-4D-21, as amended in 1981, the Commissioner promulgated N.J.A.C. 10:69A-6.2, which provided:

(a) Any single permanent resident of New Jersey who is 65 years of age and over or who is under 65 and over 18 years of age and is receiving Social Security Title II disability benefits must have an annual income of less than $12,000 to be eligible for PAAD.
(b) Any married permanent resident of New Jersey who is 65 years of age and over or who is under 65 and over 18 years of age and receiving Social Security Title II disability benefits must have a combined (applicant and spouse) annual income of less than $15,000 to be eligible for PAAD.
[ (Emphasis added).]

In 1982, several bills were introduced in the Legislature that would have expanded the Pharmaceutical Assistance Program to include persons receiving disability benefits from some program other than Social Security. See A-1268 (extending benefits to citizens receiving disability benefits from any federal source); A-1503 (extending benefits to those disabled under any federal or New Jersey law providing permanent disability benefits); S-1589 (extending benefits to persons receiving dis[361]*361ability'payments from the Federal Railroad Retirement program, the Federal Civil Service retirement program, and those rated as “totally disabled” by the Veteran’s Administration). Each of these bills would have resulted in a significant increase in program expenses 1 and was defeated.

In 1985 the Legislature amended N.J.S.A. 30:4D-21 to raise the income eligibility limits and to explicitly provide that a disabled person must actually be receiving SSDI benefits in order to qualify for the Pharmaceutical Assistance Program:

Any resident of this State who is either a recipient of Disability Insurance benefits under Title II of the federal Social Security Act (42 U.S.C.

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Cite This Page — Counsel Stack

Bluebook (online)
526 A.2d 1055, 107 N.J. 355, 1987 N.J. LEXIS 324, Counsel Stack Legal Research, https://law.counselstack.com/opinion/barone-v-department-of-human-services-nj-1987.