Stowell v. Rollin Ives

• Court: Court of Appeals for the First Circuit
• Decided: September 28, 1992
• Docket: 92-1342
• Status: Published

Opinion

USCA1 Opinion

September 28, 1992

_________________________

          No. 92-1342

                           CHRISTINE STOWELL, ETC., ET AL.,
                               Plaintiffs, Appellants,

                                          v.

                                H. ROLLIN IVES, ETC.,
                                 Defendant, Appellee.

                              _________________________

                     APPEAL FROM THE UNITED STATES DISTRICT COURT

                              FOR THE DISTRICT OF MAINE

                       [Hon. Gene Carter, U.S. District Judge]
                                          ___________________

                               ________________________

                                        Before

                        Selya, Cyr and Stahl, Circuit Judges.
                                              ______________
                              _________________________

               James  R. Crotteau,  with whom  Pine Tree  Legal Assistance,
               __________________              ____________________________
          Inc. was on brief, for appellants.
          ____
               J. Paterson Rae and  Hugh Calkins on joint brief  for Robert
               _______________      ____________
          Avanzato,  Michelle Turcotte,  Maine Civil  Liberties Union,  and
          Maine  Chapter  of the  National  Organization  for Women,  amici
          curiae (in support of the appeal).
               Christopher C. Leighton,  Deputy Attorney General,  State of
               _______________________
          Maine,  with whom  Michael  E. Carpenter,  Attorney General,  and
                             _____________________
          Thomas D.  Warren, Deputy Attorney  General, were  on brief,  for
          _________________
          appellee.
               Richard   A.  Olderman,  Attorney,  Appellate  Staff,  Civil
               ______________________
          Division,  U.S. Dept.  of Justice,  with whom  Stuart M.  Gerson,
                                                         _________________
          Assistant   Attorney  General,   Barbara  C.   Biddle,  Attorney,
                                           ____________________
          Appellate Staff,  and Richard  S. Cohen, United  States Attorney,
                                _________________
          were on brief, for  the United States, amicus curiae  (in support
          of the judgment below).

                              _________________________

_________________________

SELYA, Circuit Judge.  Once  the  wheat is  shaken from
                    SELYA, Circuit Judge.
                           _____________

          the  chaff, this  apparently complex  appeal can  be resolved  by

          deciding a threshold question (albeit one that has not previously

          been  confronted by  the courts  of appeals).    Consequently, we

          affirm the district court's entry  of judgment for the  defendant

          on  the basis  that  a recipient  of  benefits under  the Aid  to

          Families  with Dependent  Children program  (AFDC), 42  U.S.C.   

          601-615 (1988 & Supp. I 1989), cannot bring an action pursuant to

          42  U.S.C.    1983 (1988)  to enforce  the terms  of 42  U.S.C.  

          1396a(c)(1) (1988).

          I.  BACKGROUND
          I.  BACKGROUND

                    Since  this  matter turns  on  a  discrete question  of

          redressability, our burden  of exegesis is  considerably reduced.

          We content  ourselves, therefore, with sketching  the contours of

          the  preliminary inquiry,  forgoing  detailed  exposition of  the

          facts and substantive issues.

                    We start with section 1396a(c)(1), a statute enacted on

          July 1, 1988 as  part of the Medicare Catastrophic  Coverage Act.

          The statute reads in pertinent part:

                    [T]he   Secretary   [of  the   United  States
                    Department  of  Health  and  Human  Services]
                    shall not  approve any State plan for medical
                    assistance if  
                         (1)  the  State  has  in  effect  [AFDC]
                    payment levels that are less than the payment
                    levels in  effect under  such plan on  May 1,
                    1988.

          42 U.S.C.   1396a(c)(1).

                    On February  21, 1992,  Christine Stowell  brought suit

          for declaratory and injunctive relief in Maine's federal district

                                          2

court.    She  invoked 42  U.S.C.    1983,  named  a  Maine state

          official as  a defendant,1  and claimed  that Maine  had violated

          section 1396a(c)(1).    The  claim  rested on  the  premise  that

          economy measures  implemented by  the Maine legislature  had gone

          too far, resulting in a de facto reduction of AFDC payment levels
                                  __ _____

          below  those in  effect  on May  1,  1988.   The State  contested

          Stowell's standing  to sue  and, moreover, asserted  that payment

          levels had been  increased rather than decreased.2   On Stowell's

          motion,  the trial  court certified  a plaintiff  class which  it

          described as follows:

                    All families in the  State of Maine who would
                    be   eligible   for   AFDC  benefits   and/or
                    supplemental  payments  under  42   U.S.C.   
                    602(a)(28)  under the AFDC  payment levels in
                    effect in Maine  on May 1, 1988 and who would
                    receive   a   smaller    total   AFDC    plus
                    supplemental   602(a)(28)  payment under  the
                    AFDC  payment levels proposed to be effective
                    March 1,  1992 than they would  have received
                    under the May 1, 1988 payment levels.

          Stowell v. Ives, 788 F. Supp. 40, 40 n.1 (D. Me. 1992).
          _______    ____

                    In  time, the case was  submitted to the district court
                              
          ____________________

               1Stowell   sued  H.   Rollin  Ives,   in  his   capacity  as
          Commissioner of  the Maine Department  of Human Services.   Since
          Maine is  the real party in interest,  we will sometimes refer to
          Ives as "the State."   Stowell also sued a  federal official, the
          Secretary  of  the  Department   of  Health  and  Human  Services
          ("Secretary").   However, she dropped the Secretary from the case
          prior  to  the  entry of  judgment  below.    Thus, although  the
          Secretary filed an amicus  brief and argued before us  in support
          of the judgment, he is not a party to this appeal.

               2The parties'  differing views as to the practical effect of
          Maine's regulations  stem from their differing interpretations of
          the term "payment levels."  See Stowell v. Ives, 788 F. Supp. 40,
                                      ___ _______    ____
          41-42 (D.  Me. 1992).   Because  we do not  reach the  merits, we
          express  no opinion on the proper resolution of this interpretive
          conundrum.

                                          3

on  a  stipulated  record.   The  court  ruled  that the  amended

          complaint  failed to  state a  cause of  action cognizable  under

          section 1983.  Id. at 44.  This appeal ensued.
                         ___

          II.  DISCUSSION
          II.  DISCUSSION

                    Section  1983 provides  a federal  cause of  action for

          "the deprivation of any rights, privileges, or immunities secured

          by  the Constitution and [federal] laws."   42 U.S.C.   1983.3  A

          prospective  plaintiff may bring suit under section 1983 not only

          for a state actor's violation of his or her constitutional rights

          but  also to  enforce  federal  statutory  law  in  the  face  of

          infringing state officialdom.   See Maine v.  Thiboutot, 448 U.S.
                                          ___ _____     _________

          1, 4-8 (1980).

                    Nevertheless,  not every violation of federal law gives

          rise to  a section 1983 claim.  See Golden State Transit Corp. v.
                                          ___ __________________________

          Los  Angeles,  493  U.S. 103,  106  (1989).    Exceptions include
          ____________

          situations where "Congress has foreclosed such  enforcement . . .

          in  the enactment itself" or where "the statute [does] not create

          enforceable rights, privileges, or immunities within  the meaning

          of   1983."   Suter v. Artist  M., 112 S.  Ct. 1360, 1366  (1992)
                        _____    __________

          (quoting  Wright v.  Roanoke Redevelopment  & Housing  Auth., 479
                    ______     _______________________________________

          U.S. 418, 423 (1987)); accord Wilder v. Virginia Hosp. Ass'n, 496
                                 ______ ______    ____________________

          U.S. 498, 508 (1990).   Because 42 U.S.C.   1396a(c)(1)  does not

          expressly  outlaw  section  1983  actions,  the  first  of  these

          exceptions is inapposite here.  Accordingly, we focus the lens of

____________________

               3For ease in reference, we will henceforth use "rights" as a
          shorthand abbreviation for "rights, privileges, or immunities."

                                          4

our perlustration on the second exception, bent on determining to

          what  extent   (if  at  all)  section   1396a(c)(1)  creates  any

          enforceable rights.

A.
                                          A.
                                          __

                    Prior to 1992, cases  such as Wilder v. Virginia  Hosp.
                                                  ______    _______________

          Ass'n, 479 U.S.  418 (1990),  Pennhurst State School  & Hosp.  v.
          _____                         _______________________________

          Halderman, 451 U.S.  1 (1981), and Rosado v. Wyman,  397 U.S. 397
          _________                          ______    _____

          (1970), guided judicial  inquiry into whether a  federal law did,

          or did not,  create a right falling  within the ambit  of section

          1983.  Under that framework, a court's  first duty was to satisfy

          itself that "the [statutory] provision in question was intend[ed]

          to  benefit the  putative plaintiff."   Wilder,  496 U.S.  at 509
                                                  ______

          (citations  and internal quotation  marks omitted).   If  no such

          benefit  could be  gleaned,  the  court's  inquiry  ended.    If,

          however, the court  perceived an  intended benefit,  then it  was

          bound to  find that  the provision created  an enforceable  right

          unless one of two  conditions obtained:  either (1)  the statute,

          fairly read, "reflect[ed] merely a congressional preference for a

          certain kind of conduct  rather than a binding obligation  on the

          governmental unit," or (2) the interest asserted by  the putative

          plaintiff was so  "vague and amorphous" that enforcement would be

          "beyond the competence  of the judiciary. . .  ."  Id. (citations
                                                             ___

          and internal  quotation marks omitted).   Accord Playboy Enters.,
                                                    ______ ________________

          Inc.  v. Public Serv.  Comm'n, 906 F.2d 25,  32 (1st Cir.), cert.
          ____     ____________________                               _____

          denied, 111 S. Ct. 388 (1990).
          ______

5

During  the  last term,  the  old regime  fell  on hard

          times.   The Court decided Suter,  112 S. Ct. 1360,  a case which
                                     _____

          shed new light on this fuliginous area of the law.  Although some

          respected jurists believe that Suter effected a sea change in the
                                         _____

          Court's  approach to section  1983, e.g., id.  at 1371 (Blackmun,
                                              ____  ___

          J.,  dissenting) ("In  my  view,  the  [rationale  of  the  Suter
                                                                      _____

          majority] is plainly inconsistent with this Court's decision just

          two years ago in  Wilder . . . ."), we think it is much too early
                            ______

          to post  epitaphs for Wilder and  its kin.  For  one thing, Suter
                                ______                                _____

          offered no analytic framework to replace the structure erected in

          the Court's  previous decisions.   For  another thing,  the Suter
                                                                      _____

          Court, while  weakening earlier precedents  in certain  important

          respects,  was careful not explicitly  to overrule them.  Indeed,

          the majority  relied on those precedents  as pertinent authority.

          See,  e.g., Suter,  112 S.  Ct. at  1366-68 (citing,  inter alia,
          ___   ____  _____                                     _____ ____

          Wilder,  Pennhurst, and Wright).   Because we believe  that it is
          ______   _________      ______

          both  prudent and possible  to synthesize the  teachings of Suter
                                                                      _____

          with the Court's prior  precedents, we examine appellants' claims

          under  the  Wilder  framework  as reconfigured  by  the  neoteric
                      ______

          principles announced in Suter.
                                  _____

                                          B.
                                          B.
                                          __

                    AFDC  and Medicaid,  42  U.S.C.     1396-1396u (1988  &

          Supp. I 1989),  as amended by Acts  of Nov. 5, 1990 and  Dec. 19,
                          __ _______ __

          1989,  42 U.S.C.S.     1396-1396u  (Law. Co-op. Supp.  1992), the

          programs  at issue  here, are  part of  the Social  Security Act.

          Both  endeavors represent  examples of  cooperative federal-state

6

social service  programs which, though federally  funded in whole

          or in part,  are administered  by the States.   See Alexander  v.
                                                          ___ _________

          Choate,  469 U.S.  287,  289 n.1  (1985) (Medicaid);  Doucette v.
          ______                                                ________

          Ives,  947 F.2d  21,  23  (1st  Cir.  1991)  (AFDC).    "Although
          ____

          participation  in  [such  programs]  is  voluntary, participating

          States  must  comply with  certain  requirements  imposed by  the

          [federal statutes] and regulations  promulgated by the  Secretary

          of Health and Human Services."  Wilder, 496 U.S. at 502; see also
                                          ______                   ___ ____

          King v. Smith, 392 U.S. 309, 316 (1968).
          ____    _____

                    To  be  sure, "the  Supreme  Court  has implicitly  and

          explicitly  held  that rights  under  various  provisions of  the

          Social  Security Act are enforceable under  section 1983."  Lynch
                                                                      _____

          v. Dukakis,  719  F.2d  504,  510  (1st Cir.  1983).    But  that
             _______

          generality, without  more, does not boost  the appellants' stock.

          Suter  reminded us that each provision of the Social Security Act
          _____

          "must be interpreted  by its own  terms."  Suter,  112 S. Ct.  at
                                                     _____

          1367 n.8.  In performing this tamisage, the abecedarian principle

          is that statutory interpretation  always starts with the language

          of the statute  itself.   Pennsylvania Dep't of  Pub. Welfare  v.
                                    ___________________________________

          Davenport,  495 U.S.  552, 557-58  (1990); Consumer  Prod. Safety
          _________                                  ______________________

          Comm'n v. GTE Sylvania, Inc., 447  U.S. 102, 108 (1980).  A court
          ______    __________________

          should  "assum[e] that  the ordinary  meaning of  [the statutory]

          language  accurately  expresses  the  legislative  purpose,"  see
                                                                        ___

          Morales  v. Trans  World Airlines,  Inc., 112  S. Ct.  2031, 2036
          _______     ____________________________

          (1992), and should "resort  to the legislative history  and other

          aids of statutory construction only when the literal words of the

7

statute  create ambiguity  or  lead to  an unreasonable  result."

          United States v. Charles  George Trucking Co., 823 F.2d  685, 688
          _____________    ____________________________

          (1st Cir. 1987) (citation  and internal quotation marks omitted);

          accord Barnhill v. Johnson,  112 S. Ct. 1386, 1391  (1992); Toibb
          ______ ________    _______                                  _____

          v. Radloff, 111 S. Ct. 2197, 2200 (1991).
             _______

                    We discern  no ambiguity here.   In order  to establish

          the  existence  of  a right  redressable  under  section 1983,  a

          plaintiff  must  allege that  a  particular  statute (or  federal

          constitutional provision)  imposes an obligation upon  the State.

          See  Wilder, 498  U.S.  at 509-10;  Pennhurst,  451 U.S.  at  19;
          ___  ______                         _________

          Playboy  Enters., 906  F.2d at  32.   This statute  imposes none.
          ________________

          Rather, it simply and forthrightly provides, in haec  verba, that
                                                          ____  _____

          "the  Secretary  shall not  approve  any State  plan  for medical

          assistance"  if the State  has reduced AFDC  payment levels below

          the  level prevailing on May  1, 1988.   42 U.S.C.   1396a(c)(1).

          By  its express  terms, section  1396a(c)(1) obliges  the federal

          government,  in the person of  the Secretary of  Health and Human

          Services    not the State    to take  action.  The  statute could

          scarcely be clearer.

                    Moreover,   there   is   nothing   unreasonable   about

          Congress's choosing to work its will in this way.  States are not

          obligated  by federal law to  sponsor medical assistance plans or

          to accept federal funds for  this purpose.  See 42 U.S.C.    1396
                                                      ___

          (1988);  see also  Wilder,  496  U.S.  at  502.    Thus,  section
                   ___ ____  ______

          1396a(c)(1),   without   mentioning  state   officials   at  all,

          effectively gives them a  choice:  they may either  maintain AFDC

8

benefits at or above the May 1, 1988 payment levels,  or they may

          reduce  benefits.   If they  choose the  former course     and we

          emphasize, at this juncture, that Maine adamantly insists that it

          has  maintained (or increased) AFDC  payment levels   the State's

          medical assistance plan retains eligibility for continued federal

          funding.  If state  officials choose the latter course,  however,

          continued federal funding will be jeopardized.  In that event, it

          becomes  the  Secretary's  task,  in  due  season,  to  implement

          Congress's  directive  by  withholding approval  of  the  State's

          medical assistance plan.   The State's role under the  statute is

          purely procedural. 

                    Phrased  another  way,  section   1396a(c)(1)  provides

          incentives    not commands   to the  States.  That Congress would

          name a  federal intermediary  (the Secretary) to  implement these

          federally created  incentives is  not surprising.   The potential

          reasons for such a delegation are multifarious.  They include the

          advantage  of  uniform interpretation,  the  yen  to develop  and

          harness  administrative   expertise   in  the   area,   and   the

          desirability  of maintaining  an  agent capable  of  face-to-face

          discussions  with state  officials.   Structuring the  statute in

          this fashion may neither  suit plaintiffs' preference nor advance

          their litigating  position    but there is  nothing unreasonable,

          absurd, or irrational about the model.

                    In a  nutshell, then, a straightforward  reading of the

          statutory text ends this case.  In Suter, the Court  held that an
                                             _____

          intended recipient  of programmatic benefits could  not sue under

9

section 1983  if the  federal  statute merely  required that  the

          State  submit  a plan  to  a  federal agency  satisfying  certain

          criteria,  because such  a "requirement  only goes  so far  as to

          ensure that the State have a plan approved by the Secretary which

          contains [the listed  criteria]."   Suter, 112 S.  Ct. at  1367.4
                                              _____

          Thus, Suter instructs that,  when a provision in a  statute fails
                _____

          to  impose a direct obligation on the States, instead placing the

          onus of  compliance with the statute's  substantive provisions on

          the  federal  government, no  cause  of  action cognizable  under

          section  1983 can flourish.  Compare Clifton v. Schafer, ___ F.2d
                                       _______ _______    _______

          ___,  ___ (7th  Cir. 1992)  [1992 WL  164048 at  *6-*7] (adopting

          substantially  identical   view  of  Wilder/Suter   interface  in
                                               ______ _____

          delineating scope of  AFDC recipient's right to sue under section

          1983  in order  to enforce  provisions of  42 U.S.C.    602(a)(4)

          (1988)).  So it is here.

                                          C.
                                          C.
                                          __

                    Our holding today finds additional support in a line of

          cases  dealing with  a closely  related issue:   implied  private

          rights of  action.  We are  cognizant that the tests  utilized in

          ascertaining whether  a section 1983  cause of action  exists and

          those  utilized in determining the propriety  of an implied right

          of  action are "analytically distinct."   See Playboy Enters, 906
                                                    ___ ______________

____________________

               4In  order  to  facilitate  comparison  with  the  statutory
          provision before us  today, we note that 42 U.S.C.    671(a), the
          statute which was before the  Suter Court, read as follows:   "In
                                        _____
          order for a State to be eligible for payments under this part, it
          shall  have a  plan approved  by  the Secretary  which" satisfies
          certain criteria.

                                          10

F.2d at  31.   However, these two  legal theories  bear a  family

          resemblance.  See Victorian v. Miller, 813 F.2d 718, 720 n.3 (5th
                        ___ _________    ______

          Cir. 1987) ("Section 1983 . . . allows private parties to enforce

          federal  laws against a special  class of defendants    state and

          municipal actors    in much the  same way that implied  rights of

          action   permit   private   enforcement  of   federal   statutory

          obligations against  any party, public or  private."); Samuels v.
                                                                 _______

          District  of  Columbia,  770  F.2d  184,  194  (D.C.  Cir.  1985)
          ______________________

          (similar);  Polchowski v.  Gorris, 714  F.2d 749,  751 (7th  Cir.
                      __________     ______

          1983) (stating that  the inquiry concerning  a putative cause  of

          action  under  section  1983  "resembles  the  analysis  used  to

          determine whether a private  cause of action may be  implied from

          an enactment of  Congress"); see  also  Wilder,  496 U.S. at  526
                                       ___  ____  ______

          (Rehnquist, C.J., dissenting) (remarking on the "significant area

          of overlap" between the two theories).5

                    In the context of implied rights of action, the Supreme

          Court has held that "there  'would be far less reason to  infer a

          private remedy  in favor  of individual persons'  where Congress,

          rather than drafting the  legislation 'with an unmistakable focus

          on the benefitted  class,' instead has framed  the statute simply
                              
          ____________________

               5The major difference between the two doctrines concerns the
          way in which  Congress's intent must be  manifested.  There is  a
          presumption against implied rights of action   a presumption that
          will endure unless the plaintiff proffers adequate  evidence of a
          contrary congressional intent.  The presumption works exactly the
          other way in the section 1983 milieu; it is assumed that Congress
          meant to allow such  suits   an assumption which  persists unless
          the defendant musters adequate evidence of Congress's prohibitory
          intent.  See  Victorian, 813 F.2d  at 721; Samuels,  770 F.2d  at
                   ___  _________                    _______
          194; Boatowners &  Tenants Ass'n,  Inc. v. Port  of Seattle,  716
               __________________________________    ________________
          F.2d 669, 674 (9th Cir. 1983).

                                          11

as  a . . . command to  a federal agency."  Universities Research
                                                      _____________________

          Ass'n, Inc. v. Coutu, 450 U.S. 754, 772 (1981) (quoting Cannon v.
          ___________    _____                                    ______

          University of Chicago, 441 U.S. 677, 690-92 (1979)).  The Seventh
          _____________________

          Circuit  has transposed  this reasoning  to section  1983 claims.

          See Polchowski, 714 F.2d at 751.  We think the soil is hospitable
          ___ __________

          to  such  transplantation.   A  statute  does  not  create rights

          redressable   under   section   1983  when   it   is  essentially

          administrative in  nature and  imposes an  obligation exclusively

          upon federal officials, not upon state actors.

                                          D.
                                          __

                    Though their  craft  is irreparably  holed,  appellants

          struggle  gamely to stay afloat.   We briefly  address their more

          buoyant  authorities.    First  and  foremost,  appellants  cling

          tenaciously  to  a footnoted  example of  the  Suter Court.   See
                                                         _____          ___

          Suter, 112  S. Ct.  at 1369  n.12.   But,  had appellants  looked
          _____

          closely, they  would have discerned that,  from their standpoint,

          footnote 12 is more a hungry shark than a life raft.  

                    In  this respect, appellants'  argument hinges on their

          attempt  to analogize section 1396a(c)(1) to 42 U.S.C.   672(e)  

          a  statute identified  by  the Court  as  the sort  of  statutory

          provision that would support  a section 1983 action.   Suter, 112
                                                                 _____

          S. Ct.  at 1369 n.12.   In point of fact,  section 1396a(c)(1) is

          identical,  in relevant respects,  not to  section 672(e)  but to

          section  671(a)(15)    the  statutory  provision  that the  Suter
                                                                      _____

          Court,  in footnote 12, was contrasting with section 672(e).  The
                                      ___________

          Court  deemed  it  noteworthy  that  section  671(a)(15) requires

12

"submission  of a  plan to  be approved  by the  Secretary" while

          section 672(e) provides  that "[n]o Federal payment  may be made"

          unless  certain conditions are  met.   Id.   In other  words, the
                                                 ___

          Suter  Court distinguished  between cases  in which,  on  the one
          _____

          hand, a statutory provision  is, in effect, a communication  to a

          specific  federal official  whose approval  is required  prior to

          disbursement of federal funds  (section 671(a)(15)), and cases in

          which, on the other hand, a  statutory provision is, in effect, a

          communication from Congress  to those States that  elect to apply

          for earmarked  funds (section 672(e)).  Provisions  of the former

          sort    such as  those at  issue  here and  in Suter    will  not
                                                         _____

          support a section 1983 action.

                    The other authorities  cited by appellants  to buttress

          their contention that a right  enforceable under section 1983  is

          inherent in section 1396a(c)(1)  are equally inapposite.  Without

          exception, those  cases concern  statutes that  pin hard-and-fast

          obligations on the  States.   In Wilder, for  example, the  Court
                                           ______

          concluded that the Boren  Amendment, 42 U.S.C.   1396a(a)(13)(A),

          could support the maintenance of a  section 1983 action.  But, as

          the  Wilder  Court found,  the  Boren  Amendment requires  States
               ______

          participating  in the  Medicaid program  to  devise reimbursement

          rates vis-a-vis health-care providers  which "the State finds are

          reasonable  and adequate" to meet the cost which must be incurred

          by efficiently and economically operated facilities.  Wilder, 496
                                                                ______

13

U.S.   at  512   (quoting  previous  version   of  42   U.S.C.   

          1396a(a)(13)(A)).6  Similarly, in Rosado,  the Court dealt with a
                                            ______

          statutory provision that mandated  the States to reevaluate their

          need equations  and  adjust  levels of  need  accordingly.    See
                                                                        ___

          Rosado, 397  U.S. at 412.   As  we have explained,  no comparable
          ______

          obligation is imposed on the States by section 1396a(c)(1).

III.  CONCLUSION
          III.  CONCLUSION

                    We need go no  further.  Having pegged our  analysis of

          this case  on the Wilder framework, visualized  through the Suter
                            ______                                    _____

          prism,  we  conclude that,  because  the  Secretary is  the  only

          government  official, federal  or  state, directly  bound by  the

          requirements  of section  1396a(c)(1),  appellants  cannot  bring

          their suit within the ambit of section 1983.

Affirmed.
          Affirmed.
          ________

____________________

               6The earlier version, 42 U.S.C.   1396a(a)(13)(A) (1982 ed.,
          Supp. V), mirrors the present version in all respects material to
          the case at hand.

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