matter coverage that to expand it and it doesn't appear to be having to do with any type of medical treatment there's really no indication as to what this man set conditions for i mean it doesn't really have anything to it if you look at the almost all of them indicate that the statute is very to this again that the legal standard authorized by congress and what i'm getting is that they don't make a specific finding that will qualify for your respective of the sudden onset what then becomes the ultimate remedy indicated they don't say it's not an urgent medical condition but they say sudden onset is the only reason that they didn't find their way if you look at their actual decisions was it was nasa and i guess you are saying we're parsing over the same issue are are you asking us to read between the lines or there was a specific finding by the department that this was an emergency medical condition they're not necessarily the same thing but i think if you get if you look at the position the parents here if you look at the and has to even see properly applied the relevant rule of law now when i bridge the argument in the beginning it looked to me like the main contention of the plaintiff was that the agency had misapplied the rule of law because it didn't see when there was about what a sudden i'm sorry what emergency medical condition is that case a federal court the second circuit found that it was clear unambiguous and then require a temple component a suddenness and unexpected ss that language has worked its way into the state case the state law certainly we don't have any cases and it looks like mr brother has done a fine job collecting all the ones you can find move how many cases that go back  into the cases all seem to go forward in time the question that we see over and over in the cases that are citing is a person comes to the hospital and how much is the medical condition the hospital cerys at what point does it stop being an emergency medical condition that's a very hard specific questions issue here which is what is the medicaid statute mean when it says it and because it comes before the agency i think reasonably follows the federal law as it was articulated in greenery  to congress could change the statute to make clear that sudden onset is an impermissible requirement and it didn't so the inference the state drawn is i think a more reasonable one is that in twenty years of this being an issue is the term emergency medical condition and tala doesn't have a sudden onset requirement in fact a sudden onset requirement in the intolerant test with greatly undermine the way that statute works because we don't want people in an emergency room caring for patients asking for help to get this way how long have you been this way before they provide treatment tal is all about getting people treatment right away the medicaid statues about how it should be paid for if it should be paid for get the attorney general out of the picture and i'm most comfortable with that because that would put the people who do this all the time in charge of making the decision that they are sexually charged with me and that way there's no question about the attorney general con situation the agency should get deference and stronger said and when they began she had suffered with that she she presented she said she's having trouble breathing that's how she presented to the doctors she had been having trouble breathing treatment by the way the hospital because under the intolerance statute there is a sudden onset requirement she gets treated the question is whether the state has to pay for it and you know the fairness or unfairness that i don't want to have to get into that argument because i just think it's it's it's a it's a the more interesting question is the first one obviously if the court changes the sudden onset requirement i think that you really have to be turning the out the car you've got a lot of law on syria now with regulations and none of those in policy and homes other stuff talking about sudden onset if it goes away the program becomes a much bigger program and i think it might become a much bigger problem not only in illinois but in other states too because the federal regulation that we're talking about is not comedy and  bitterly about the financial burdens of caring for undocumented aliens in congress i'm told this in the legislation that we was in two thousand actually providing for some relief for hospitals that cause problems to congress and no purposes of determining who pays for the treatment that was ran but you're suggesting it said nasa has no place and has never place in determining who gets treatment if they walk into an urgency room it's exactly  hospital allegations to treat her hand in the hospitals or coming in and when she's stable and the judge in the case said no she's still got emergency medical condition even though she's stable and it gets to be announced it's not this case but in this case should be as you point out she describe what an emergency medical condition is completely consistent with the federal regulations and with the state regulations in this case so sudden onset is very much an issue in the greenery i would argue that th prime auto insurance carrier were you know you yes they're they're saying there is no pain whatsoever for this condition there was a sudden and we're seeing is because symptoms less than two weeks or three weeks before the person presenting the emergency room if there's no said nancy we're denying the claim entirely which means wouldn't pay for aftercare but it would pay for the period of time that she was india brazil room and then she was obviously transferred immediately up into it to keep care inpatient and she was there for eighteen days so basically would cover the entire period of time and know history and she reported no health issues whatsoever but there was nothing from the diagnosis that turned she any prior health issues whatsoever so she was helping the mother of five children thirty seven years old working you know minimum wage or less and she was you know poor obviously but she was working was