Vance v. Hegstrom

793 F.2d 1018, 55 U.S.L.W. 2047
CourtCourt of Appeals for the Ninth Circuit
DecidedJuly 1, 1986
DocketNos. 85-4050, 85-4065
StatusPublished
Cited by35 cases

This text of 793 F.2d 1018 (Vance v. Hegstrom) 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
Vance v. Hegstrom, 793 F.2d 1018, 55 U.S.L.W. 2047 (9th Cir. 1986).

Opinion

THOMPSON, Circuit Judge:

State appellants Hegstrom and Putnam (No. 85-4050) and federal appellant Secretary of Health and Human Services Bowen (No. 85-4065) appeal the district court’s order granting summary judgment in favor of appellees. 629 F.Supp. 747. The sole issue on appeal is whether sibling income, which a state must include in computing income available to a family to determine AFDC eligibility under 42 U.S.C. § 602(a)(38), may be included in computing that family’s available income to deny Medicaid benefits. We hold that it cannot and we affirm the judgment of the trial court.

I

FACTS

This case involves an interpretation of Title XIX of the Social Security Act, as amended, 42 U.S.C. § 1396 et seq. (Medicaid) and its relation to Title IV-A of the Social Security Act, as amended, 42 U.S.C. § 601 et seq. Title IV-A is more commonly known as Aid to Families with Dependent Children (AFDC). Both programs are cooperative federal-state efforts that enable states to provide assistance to needy families and individuals. See Lynch v. Rank, 747 F.2d 528, 530 (9th Cir.1984), modified and granting reh’g, 763 F.2d 1098 (9th Cir.1985); 42 U.S.C. §§ 601, 1396. Although states are not required to participate in the AFDC or Medicaid programs, participating states must have their programs approved by the Secretary of Health and Human Services. Cubanski v. Heckler, 781 F.2d 1421, 1423 (9th Cir.1986); 42 [1020]*1020U.S.C. §§ 602(b), 1396a(a). Oregon has elected to participate in both programs.

1. Medicaid

States electing to provide Medicaid benefits must cover “categorically needy” individuals. Cubanski, 781 F.2d at 1423; Lynch, 747 F.2d at 530 n. 1; 42 U.S.C. § 1396a(a)(10)(A); 42 C.F.R. § 435.100. “Categorically needy” individuals are those persons receiving AFDC or those “who would be eligible for AFDC except for an eligibility requirement used in that program that is specifically prohibited under [Medicaid].” 42 U.S.C. § 1396a(a)(10)(A)(i)-(I); 42 C.F.R. §§ 435.4, 435.100 et seq.

Standards for determining Medicaid eligibility are set forth in 42 U.S.C. § 1396a(a)(17). Schweiker v. Hogan, 457 U.S. 569, 574, 102 S.Ct. 2597, 2601, 73 L.Ed.2d 227 (1982). That section provides, in part, that a state’s Medicaid plan must:

[I]nclude reasonable standards ... for determining eligibility for and the extent of medical assistance under the plan which ...
(B) provide for taking into account only such income and resources as are, as determined in accordance with standards prescribed by the Secretary, available to the applicant or recipient and ...
(D) do not take into account the financial responsibility of any individual for any applicant or recipient of assistance under the plan unless such applicant or recipient is such individual’s spouse or such individual’s child who is under age 21 or ..., is blind or permanently and totally disabled, ...

42 U.S.C. § 1396a(a)(17).

Subsection (17)(B) grants the Secretary broad powers to set standards to determine what income is available to a Medicaid recipient. Herweg v. Ray, 455 U.S. 265, 274, 102 S.Ct. 1059, 1066, 71 L.Ed.2d 137 (1982); Schweiker v. Gray Panthers, 453 U.S. 34, 43-44, 101 S.Ct. 2633, 2639-40, 69 L.Ed.2d 460 (1981). However, subsection (17)(D) precludes a state from “deeming,” 1 as income available to a Medicaid applicant, income from persons other than the applicant’s spouse, or parent if the applicant is under twenty-one, blind, or disabled. 42 U.S.C. § 1396a(a)(17)(D). Herweg, 455 U.S. at 275 & n. 13, 102 S.Ct. at 1067 n. 13.

2. AFDC

Aid to Families with Dependent Children was enacted to “encourag[e] the care of dependent children in their own homes or in the homes of relatives____” 42 U.S.C. § 601. Medberry v. Hegstrom, 786 F.2d 1389, 1389-90 (9th Cir.1986). The goal of the program is “to help maintain and strengthen family life and to help [parents or relatives of dependent children] to attain or retain capability for the maximum self-support and personal independence consistent with the maintenance of continuing parental care and protection, ...” 42 U.S.C. § 601. To achieve this goal, federal funds are made available to the states to “en-abl[e] each State to furnish financial assistance and rehabilitation and other services, ...” Id.

The Secretary’s regulations require that states provide Medicaid to individuals receiving AFDC. 42 C.F.R. § 435.110(a). For purposes of section 435.110, “an individual is receiving AFDC if his needs are included in determining the amount of the AFDC payment” to be received by a family with dependent children. 42 C.F.R. § 435.-110(b). To qualify for AFDC benefits, individuals must meet certain standards of financial need, as defined by their income and resources. 42 U.S.C. § 602(a).

Applicants for AFDC are called family filing units. Prior to 1984, a family applying for AFDC benefits could exclude from the filing unit those family members whose [1021]*1021income and/or resources, if counted in the overall family income and resources, would make the family ineligible for AFDC benefits.

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793 F.2d 1018, 55 U.S.L.W. 2047, Counsel Stack Legal Research, https://law.counselstack.com/opinion/vance-v-hegstrom-ca9-1986.