Marsha Francine Modderno v. James B. King, Director, U.S. Office of Personnel Management Agency

82 F.3d 1059, 317 U.S. App. D.C. 255
CourtCourt of Appeals for the D.C. Circuit
DecidedJuly 1, 1996
Docket94-5400
StatusPublished
Cited by59 cases

This text of 82 F.3d 1059 (Marsha Francine Modderno v. James B. King, Director, U.S. Office of Personnel Management Agency) is published on Counsel Stack Legal Research, covering Court of Appeals for the D.C. Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Marsha Francine Modderno v. James B. King, Director, U.S. Office of Personnel Management Agency, 82 F.3d 1059, 317 U.S. App. D.C. 255 (D.C. Cir. 1996).

Opinions

Opinion for the Court filed by Circuit Judge WILLIAMS.

Concurring opinion filed by Circuit Judge GINSBURG.

STEPHEN F. WILLIAMS, Circuit Judge:

Marsha Francine Modderno suffers from a mental illness that required her hospitalization from 1988 to 1991. During this period she was covered by the Foreign Service Benefit Plan by virtue of her status as the former spouse of a Foreign Service officer. In 1990 the Plan imposed a number of limitations on benefits for mental health care, limits not paralleled by similar restrictions on benefits for physical illness. Of these restrictions, the parties focus on a $75,000 lifetime maximum for mental health benefits; no one argues that the other limits (such as different thresholds for catastrophic coverage) pose any distinctive issues. Modderno claims that the limitations on mental health benefits violate § 504 of the Rehabilitation Act, 29 U.S.C. § 794, which prohibits discrimination on the basis of disability in any program conducted by an executive agency of the United States. Because the Office of Personnel Management (“OPM”) accepted the Plan in the exercise of its duty to contract for federal employees’ health insurance plans, see 5 U.S.C. § 8902, the Plan is subject to § 504.

The district court dismissed Moddemo’s complaint on the ground that it failed to state a claim upon which relief could be granted. Modderno v. King, 871 F.Supp. 40 (D.D.C. 1994). Modderno appeals the dismissal, arguing first that the version of § 504 in effect at the time OPM contracted for the new limits prohibits it from imposing a limit on mental health benefits in the absence of a matching limit regarding physical illness. Alternatively, Modderno argues that a 1992 amendment of § 504, importing standards from the Americans with Disabilities Act of 1990 (“ADA”) to § 504, prohibits what OPM has done.

In addition to these arguments, Modderno argues more generally that differential treatment of mental and physical illness is wrongheaded both as a matter of basic justice and from the perspective of a long-term prudential calculus. She says, for example, that “what may be perceived as providing equal benefits to all (such as providing the same mental benefits to everyone in a health care plan, for instance) is not actually providing equal benefits to all when the effect is to prevent one class from achieving equal access to fundamental rights.” And she urges that “[t]he growing body of social research shows that the costs of treating the mentally] ill are far less than the ultimate costs of not treating them, for workers and employers alike.” Whatever the merit of these broader arguments, we must leave them for resolution in other spheres, such as the political branches of government, markets, or the activities of eleemosynary institutions. Confining ourselves to Modderno’s legal claims under § 504 of the Rehabilitation Act, we conclude that the district court correctly dismissed the complaint.

I. Section 504 of the Rehabilitation Act

Section 504 of the Rehabilitation Act provides:

No otherwise qualified individual with a disability in the United States ... shall, solely by reason of her or his disability, be excluded from ... participation in, be denied the benefits of, or be subjected to discrimination under any ... program or activity conducted by any Executive agency....

29 U.S.C. § 794. The government conceded for purposes of the district court’s ruling on its motion to dismiss that Modderno is “otherwise qualified” to participate in the Plan (apparently as the former spouse of a covered employee) and that she is a person with a disability. See Modderno, 871 F.Supp. at 42. Thus the only question under § 504 is whether the Plan’s differential treatment of mental and physical illness excludes Modder-no from participation in, denies her the benefits of, or subjects her to discrimination within the meaning of the statute.

Moddemo’s broadest argument is that the Plan violates § 504 because it provides “unequal benefits” to persons with mental ill[1061]*1061ness. Although Moddemo does not offer a yardstick by which to measure inequality, we may fairly assume that the restrictions cause inequality, in some sense of the word, as between those disabled by mental illness and persons disabled only by physical impairments or not disabled at all. The question, however, is whether the probable inequality is the sort of harm the Rehabilitation Act was intended to redress. The Supreme Court has held unanimously that it is not. Alexander v. Choate, 469 U.S. 287, 105 S.Ct. 712, 88 L.Ed.2d 661 (1985). The Court in Alexander concluded that Tennessee’s generalized limitations on Medicaid payments, which fell disproportionately on disabled individuals because of their greater medical needs, were, not subject to challenge under § 504 merely because of that disproportion:

Section 504 seeks to assure evenhanded treatment and the opportunity for handicapped individuals to participate in and benefit from programs receiving federal assistance. The Act does not, however, guarantee the handicapped equal results from the provision of state Medicaid, even assuming some measure of equality of health could be constructed.

Id. at 304, 105 S.Ct. at 721-22 (citation omitted).

Amicus curiae for Moddemo would distinguish Alexander on the principle that the-limits disputed here constitute a “facial discrimination” between different types of disability (mental and other), whereas Alexander addressed an across-the-board limit on the number of inpatient hospital days for which Tennessee’s Medicaid program would grant reimbursement. Because of the supposed facial discrimination, amicus argues that the disputed limits are invalid unless “supported by actuarial data.”

The first difficulty with this view is that the limits contained in the Plan do not in any way track the Rehabilitation Act’s definition of disability — the only ground on which the Act forbids discrimination. The Act defines an “individual with a disability” as “any person who (i) has a physical or mental impairment which substantially limits one or more of such person’s major life activities, (ii) has a record of such an impairment, or (in) is regarded as having such an impairment.” 29 U.S.C. § 706(8)(B). Thus, the phrase “by reason of her or his disability” in § 504’s anti-discrimination command presumably means by reason of one of the things described in (i), (ii) or (iii) of 29 U.S.C. § 706(8)(B). While the definition mentions physical and mental impairments, it appears to do so only by way of assuring that the remedies provided by the Act are comprehensive, rather than to assure any kind of equality as between sufferers of mental, as opposed to physical, disability. The statute thus focuses on disability, yet the Plan in no way uses that criterion, as would, for example, a plan that distinguished between disabling and non-disabling mental illness.

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Bluebook (online)
82 F.3d 1059, 317 U.S. App. D.C. 255, Counsel Stack Legal Research, https://law.counselstack.com/opinion/marsha-francine-modderno-v-james-b-king-director-us-office-of-cadc-1996.