required to district to build the new automated eligibility system after determining process and usually renewed medical help to medicaid excuse me eligibility by checking existing databases the sweeping injunction the car requiring massive changes based on its conclusion that the district had not entirely remediated the problem its belief that its oversight was beneficial and that it had no had she relied on some of those declarations to support that point you know statistical information there was no statistical information all met all on the record shows that there are some almost ninety eight thousand e p a s p t eligible children all who in the court did not do any statistical analysis that showed that there was a problem with regard to medica eligibility that was leading to either a widespread or organ going problem with children receiving e p a s benefits the homely life portion of the settlement agreement that the court  but now my response would be the first of all the provisions with regard to medical eligibility medicaid eligibility for term i don't know of any cases that disting basically a massive change in the process the district was undergoing to bring about the improvements and changes required by the affordable cat care act with with no benefit because according to its own findings the in twenty thirteen to be along both long rocky on which is another reason that the renewal modifications at any rate are improper here to ask  in two thousand and nine when the eligibility determination provisions were terminated i assumed that those eligibility determinations include both adults and children with that was covered under the big eligibility section of the class action but that's correct and i think one of the points on the legal issues that we raised was you know that the settlement order was structure in a certain way it had separate sections that identified particular distinct set of claims the sections were sick and we also have exit criteria where the  medicaid eligibility sections were independently terminable without regard to the performance or relational the other sections so you know i mean this is why we say this what was  twenty thirteen you all call that terminated but all the district court did was say you're relieved from complying with section three of the consent order which sounds of this isn't district co one way of reading what the district court did there in his decision was say what the settlement agreement obligated you to do was stuff that is actually nonsensical now that the affordable care act imposes even more aggressive obligations on you all so one way of reading it is that what happened in twenty four teen was not a term a nation but almost a substitution we're going to erase those things that we were obliged to do because they're contrary to law and now your obligation which you all agree gone forward is to check it because i believe we've quoted it in our brief and i won't want to make sure i was quoting from the opinion itself and if it is a quote from the opinion itself moreover in that opinion the was right pretty clear vacated in court supervision and we don't have that anything like that here at least seem to me from reading the opinion in order to gather and certainly the operative language of the order that all it was  held was that he didn't have to do the mailing out know all that stuff which which federal law now said you can't do you have to do passably no laws that were the case we wouldn't have needed a motion to modify it would have a motion to hold the district in contempt of those provisions that's not what happened here so i don't think there's any i understand the language that was used but i think given the court's clear language that those provisions no longer remain in force and effect and the language which basically says to terminate it in twenty three twenty thirteen those provisions oh my think it's clear their parents application but i think a parent foster from conception washer parents today the kids themselves qualify our needs are right and i'm not certain of that but i would i would imagine that's possible but i don't want right michel but i i think you know that eligibility you know tailored to the child who was eligible for a p s the services is certainly in order that that could have been that the parties bargain which the court of pigford said is this is a requirement must in here the district was deprived of this park but i think there is a way to fail or this but it would have been do you propose  please the court in twenty fifteen that process is at the district of columbia medicaid agency for deciding medicaid eligibility application time and at the time of in your renewal or in a crisis situation the crisis prevented children and families from taining medicaid and the access to the vital medical services that medicaid eligibility provide for children up to age twenty one medicaid is the e t f t t program under the settlement order parents guardians and pregnant women have perspective rights to notice about the program if they are eligible that's paragraph fifty four of the settlement order of j two eighty six the district court found and defendants do not challenge on appeal that the evidence showed that thousands of medicaid beneficiaries have been deprived cases and backlogs and zero cases was what i saw and they have him the court cited the evidence presented by the district they were zero but then the court noted that the evidence presented on the other side by plaintiffs showed that even after the point where defendant said it was  had medicaid beneficiaries and applicants coming forward who had problems for example at j a twelve ninety four twelve ninety five the court decided that as of march ninth two thousand and sixteen after the date the district resolved but it could happen again well that's right it could happen again and the court cited specific instances where it was happening again even after the date that the district of columbia had represented all of the problems were solved the court sa oversight had been a boon rather than a hindrance at j thirteen twenty eight the court said there were systemic problems that arose during the district's implementation that may well arise again and sent this in with the standard required to get injunctive relief in this posture or to have standing to get prospective relief under los angeles first lines and this was judgment standard context is the court has no assurance that the problem's going to rise again is that submission because that wouldn't be sufficient if you were seeking an injunction the first place well we think that that essentially is the same standard we need to show that there would be irreparable harm if if injunctive relief was not it was not granted the standard for that under los angeles versus lions as a burden on you to show that's correct is going to recur to a firm belief show that is going to happen again don't forward and i guess for a class you open also mentioned in the pena as to the current state of affairs when it issued its decision it j a third thirteen ten the medicaid beneficiaries that had difficulty renewing their benefits over the telephone and the long lines that service centers and paperwork processing already discussed are likely to lead to future losses so the court had already found that based on our evidence there were long lines at service centers all around the city where people were being asked to come back another day because nobody could see them that day or to resubmit material they already submitted because the district's processes were in disarray and those materials had been lost when you're in those post judgement context there has to be a line between modifying an existing structural injunction and just getting a whole new injunction as long as we're here in front of the court what is the line how do i know whether this is modifying the existing injunction or is instead whole new injunction well your honor we submit that this is modifying the injunction under rule sixty five since the district court had an active consent decree that had been monitoring for many years where the prospective parts of the decree the e p a s t t section for children up to age twenty one and the notice section for their parents and guardians and pregnant women could not be carried out with the eligibility system when the district met a compliance standard but the conditions that arose from two thousand and thirteen to two thousand and fifteen as it tried to move to new computer systems meant that the children who were subject to our order and   services if they are not having active medicaid eligibility when the settlement was originally created my understanding from term by counsel was that those children's eligibility put aside renewal to put aside for a minute upfront eligibility was covered by the eligibility provisions that were terminated in two thousand and nine degree without we agree that the eligibility parts of the settlement order were terminated and th but as to just plain upfront eligibility that's gone so how is it just not a whole new injunction that you have to meet all the ordinary procedures for an injunction well your honor under a roof  you're making a softer for the defendant i'm talking about piling on new injunctive obligations just record so this is new laws new facts new relief so it's hard to figure out how that isn't the district court i mean this junction this report did not say it was not being cut off without notice that renewal is the same law that was sued about in one thousand nine hundred six it's the medicaid statute that provides for the applications must be taken and decided with reasonable profit as their regulations specifying forty five days is a limit amendment of the constitution which says you can't be cut off without notice which is what was happening by the thousands in two thousand and fifteen to medicaid applicants and beneficiaries and meant as a district court properly found that the two affor violations of the affordable care act had nothing to do with their twenty fifteen motion districts efforts to implement the affordable care act meant that they were no longer complying with the basic or federal law requirements about processing applications of forty five days and not putting people off that renewal without notice and judge kessler who tried the case to enter the settlement order and whose actively supervised this decree over a period of seventeen years concluded based on the record of voluminous record by both defendants and playing us that the conditions in front of the court worst such that the purposes of the order that remain the prospective purposes could not be carried out without some relief for the class and  it is nearly terra tailored to only those whose application is pending over forty five days and only those who are being cut off at renewal before that this fifth on the i have acted on their renewal application  tons only only a child or only a person whose application has been pending more than forty five days to get any relief under the order of the application part of  order itself paragraph fifty four of the settlement order says that the notice goes to parents guardians pregnant women who are medicaid eligible so i court did in july twenty sixth team was say that the the applicant or renewal candidate had to come forward and identify themselves at this trip with a good faith claim and then the district columbia could act on it so you know but the person you know if  on the application correct me if i'm wrong my understanding is the district court's order wasn't limited to people who have children it's anybody who's medicaid eligible and the district my misunderstanding  that's correct that it applies to everybody and i would hope it was that suitably tailored it's suitably tailored because it's a time limited order and as soon as the district of columbia can come forward with substantial evan that doesn't make it how does it make it t excluded from the relief they simply argued it was because she didn't think you should get any relief at all that's right that was an umbrella argument and certainly the greater including the lesser so i'm just trying to figure out how you can explain to me that suitably tailored to have this really for every medicaid applicant in the district regardless of whether they have children getting services well first we submit that for all children forty percent of those on medicaid and their parents guardians and pregnant women which we don't have a number in the in the record but certainly together with forty percent of children is the majority when i cigar and as a true for guardians that yes guardians have to be eligible for the children who could i would think it would follow the child even if they're going into someone else's care  women so so for that group we would submit that the order is suitably tailored because it's directly to them it is correct that there's another proportion of those on medicaid who do not have children for guardian make up another additional percentage which certainly puts it over half of those on medicaid are coming to those those areas that are respectively governed by the notice and by the services sections that have perspective application your time's up so thank you provisions first of all they've always been restricted to individuals who have been determined to be eligible for medicaid benefits that's right in the settlement order to seven he wanted to wait six and the settlement order as i said provides distinct remedies for the separate districts providers and is given you know in trainings and other other things that really are pending normal eligibility but finally i did want to reiterate that you know we had raised issues with the court's application of and the belated or thank you