Document ID: ./input/supremecourt_opinions/opinions/21pdf/20-1263diff_868c.pdf
Page Number: 19

2 

GALLARDO v. MARSTILLER 

SOTOMAYOR, J., dissenting 

that States may reimburse themselves for medical care fur-
nished on behalf of a beneficiary not only from the portions 
of  the  beneficiary’s  settlement  representing  compensation 
for Medicaid-furnished care, but also from settlement funds 
that compensate the Medicaid beneficiary for future medi-
cal care for which Medicaid has not paid and might never 
pay.  The Court does so by reading one statutory provision 
in  isolation  while  giving  short  shrift  to  the  statutory  con-
text, the relationships between the provisions at issue, and 
the framework set forth in precedent.  The Court’s holding
is inconsistent with the structure of the Medicaid program
and  will  cause  needless  unfairness  and  disruption.    I  re-
spectfully dissent. 

I 
Congress conditions a State’s receipt of federal Medicaid
funding, see 42 U. S. C. §1396d(b), on compliance with fed-
eral requirements for the program.  The Court today details 
at length one of these requirements: that a state Medicaid 
plan pursue reimbursement for the State’s payments where
reimbursement is available from a third party.  See ante, at 
1–3.  It  devotes  comparatively  little  attention  to  another 
central requirement: that a State not assert claims against 
the property of Medicaid beneficiaries or recipients. 

Under the Medicaid Act’s anti-lien provision, enacted in 
1965 as part of the original Act, “[n]o lien may be imposed 
against the property of any individual prior to his death on
account  of  medical  assistance”  provided  under  the  state
Medicaid plan, whether “paid or to be paid.”  §1396p(a)(1); 
see Ahlborn, 547 U. S., at 283–284.  In addition, the Act’s 
anti-recovery provision, also enacted in 1965, provides that 
“[n]o adjustment or recovery of any medical assistance cor-
rectly paid on behalf of an individual under the State plan
may be made.”  §1396p(b)(1).  Together, the anti-lien and 
anti-recovery provisions establish that acceptance of Medi-
caid does not render a beneficiary indebted to the State or