Lynch v. Rank

747 F.2d 528, 1984 U.S. App. LEXIS 16743
CourtCourt of Appeals for the Ninth Circuit
DecidedNovember 14, 1984
DocketNos. 83-2343, 84-1857
StatusPublished
Cited by17 cases

This text of 747 F.2d 528 (Lynch v. Rank) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lynch v. Rank, 747 F.2d 528, 1984 U.S. App. LEXIS 16743 (9th Cir. 1984).

Opinion

CANBY, Circuit Judge:

Plaintiffs are a class of former recipients of Supplemental Security Income (SSI) who challenge two aspects of California’s implementation of the so-called Pickle amendment to the Social Security Act (the Act). The district court granted plaintiffs’ request for a preliminary injunction, since made permanent, requiring the California Department of Health Services (DHS) to apply a more liberal standard (the “but for” test) than it had been applying to determine which individuals were entitled to the benefits of the Pickle amendment. The district court, however, refused to grant plaintiffs’ request for a preliminary injunction enjoining the DHS from deeming the Pickle beneficiary’s income and resources to be part of the income and resources of members of the beneficiary’s family for purposes of determining the eligibility of those members for Medicaid (the “deeming” requirement). Both sides appeal.

I

Congress adopted the Pickle amendment, 42 U.S.C. § 1396a (note), in order to protect the Medicaid eligibility of certain persons who had formerly received both SSI benefits under Title XVI of the Act, 42 U.S.C. § 1381 et seq., and Old Age, Survivors and Disability Insurance (OASDI) benefits under Title II of the Act, 42 U.S.C. §§ 401-433. SSI is a federally administered program providing financial assistance to aged, blind, and disabled persons whose income and resources are below certain minimum levels. OASDI is more commonly referred to as social security. OASDI [530]*530beneficiaries may also be eligible for SSI if their OASDI benefit plus other income is less than the minimum level set for SSI eligibility.

Medicaid (called Medi-Cal in California), 42 U.S.C. §§ 1396-1396p, is a federally assisted, state-administered program of medical assistance provided to families with dependent children and to aged, blind, or disabled persons whose income and resources are insufficient to meet the costs of necessary medical services. 42 U.S.C. § 1396(1). In California, as in many other states, the Medicaid program actually consists of two programs: one for the “categorically needy” and another for the “medically needy.” The categorically needy are persons who are receiving cash assistance under either the SSI program or the federally assisted Aid to Families with Dependent Children (AFDC) program, 42 U.S.C. §§ 601-615.1

Because categorical Medicaid is tied to SSI eligibility for most aged, blind, or disabled persons, a loss of SSI eligibility could have potentially severe consequences for the affected individual. This result is particularly apparent when the reason for the loss of SSI eligibility is a small increase in income. The loss of minimal SSI benefits in such cases is of no great concern. What was of major concern to members of Congress was that the individual who lost SSI benefits also lost categorical Medicaid benefits, which were often far more valuable than the slight increase in income that precipitated their loss. The loss of Medicaid benefits seemed particularly unfair where the reason for it was an OASDI automatic cost-of-living increase. Although the SSI minimum is increased by the same percentage whenever OASDI benefits are increased for inflation, a cost-of-living increase in OASDI benefits could nevertheless resdlt in a loss of SSI eligibility. There are several ways that this outcome can occur, but the one Congress appeared to have focused on involves the operation of the $20 SSI income disregard. In determining eligibility for and the amount of SSI benefits, the first $20 of OASDI or other income is disregarded. Thus a person may still be eligible for a small SSI benefit although his income exceeds the SSI minimum. However, where that income is OASDI income and there is a cost-of-living increase in OASDI, the increase in the larger OASDI benefit will exceed the increase in the SSI minimum. Because the $20 disregard is not similarly indexed to inflation, the excess OASDI income may reduce the SSI benefit to zero, causing a loss of SSI eligibility and consequent loss of categorical Medicaid.

Congress responded to this problem by enacting the Pickle amendment which is the subject of this law suit.2 The Pickle amendment requires the states to provide categorical Medicaid to any person who: (1) is entitled to OASDI benefits; (2) once received SSI benefits as well as OASDI benefits; and (3) would be eligible for SSI “except for amounts of income attributable to increases in the level of [OASDI benefits] which have occurred pursuant to [automatic cost-of-living increases in OASDI benefits].”3 The federal defendant, the Depart[531]*531ment of Health and Human Services (HHS), adopted regulations identifying the individuals referred to in the Pickle amendment. According to the regulation, Pickle amendment beneficiaries must have received SSI at one time “but [have] become ineligible for those payments because of OASDI cost-of-living increases.” 42 C.F.R. § 435.135 (1983). To comply with this regulation, DHS chose to restrict the applicability of the amendment to persons who had become ineligible for SSI “solely” because of an OASDI cost-of-living increase. In other words, the event precipitating the loss of SSI eligibility had to be an OASDI cost-of-living increase and only that. If eligibility was originally lost for any other reason, the Pickle amendment could not apply.

Plaintiffs attack this interpretation of' the amendment, arguing that a more liberal “but for” test properly identifies the amendment’s beneficiaries. Under this test, any former recipient of SSI who could requalify for SSI “but for” OASDI cost-of-living increases occurring since he or she last received SSI would be entitled to have Medicaid benefits restored without regard to the reason he or she had originally become ineligible for SSI. In support of their argument, plaintiffs rely on Ciampa v. Secretary of Health & Human Services, 687 F.2d 518 (1st Cir.1982), which adopted the “but for” test advocated by plaintiffs. The district court accepted plaintiffs’ view.

The district court’s construction of the statute is subject to de novo review. Turner v. Prod, 707 F.2d 1109, 1114 (9th Cir.1983), cert. granted, — U.S. -, 104 S.Ct. 1412, 79 L.Ed.2d 739 (1984). “As in all cases involving statutory construction, ‘our starting point must be the language employed by Congress.’ ” American Tobacco Co. v. Patterson, 456 U.S. 63, 68, 102 S.Ct. 1534, 1537, 71 L.Ed.2d 748 (1982) (quoting Reiter v. Sonotone Corp., 442 U.S. 330, 337, 99 S.Ct. 2326, 2330, 60 L.Ed.2d 931 (1979)).

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Lynch v. Rank
747 F.2d 528 (Third Circuit, 1984)

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Bluebook (online)
747 F.2d 528, 1984 U.S. App. LEXIS 16743, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lynch-v-rank-ca9-1984.