Document ID: ./input/supremecourt_opinions/opinions/21pdf/20-1263diff_868c.pdf
Page Number: 18.0

Cite as:  596 U. S. ____ (2022) 

1 

SOTOMAYOR, J., dissenting 

SUPREME COURT OF THE UNITED STATES 

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No. 20–1263 
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GIANINNA GALLARDO, AN INCAPACITATED PERSON, BY 
AND THROUGH HER PARENTS AND CO-GUARDIANS PILAR 
VASSALLO AND WALTER GALLARDO, PETITIONER 
v. SIMONE MARSTILLER, IN HER OFFICIAL CAPACITY 
AS SECRETARY OF THE FLORIDA AGENCY FOR 
HEALTH CARE ADMINISTRATION 

ON WRIT OF CERTIORARI TO THE UNITED STATES COURT OF 
APPEALS FOR THE ELEVENTH CIRCUIT 

[June 6, 2022]

 JUSTICE SOTOMAYOR, with whom JUSTICE BREYER joins,

dissenting. 

Where a Medicaid beneficiary recovers an award or set-
tlement from a tortfeasor for medical expenses, specific pro-
visions of the Medicaid Act direct a State to reimburse itself 
from  that  recovery  for  care  for  which  it  has  paid.    These 
provisions constitute a limited exception to the Act’s default 
rule  prohibiting  a  State  from  imposing  a  lien  against  the
beneficiary’s property or seeking to use any of that property
to reimburse itself.  Accordingly, a State may claim portions
of  the  beneficiary’s  tort  award  or  settlement  representing
payments for the beneficiary’s medical care, but not those
representing  other  compensation  to  the  beneficiary  (e.g., 
damages  for  lost  wages  or  pain  and  suffering).    Arkansas 
Dept.  of  Health  and  Human  Servs.  v.  Ahlborn,  547  U. S. 
268,  282–286  (2006).  This  statutory  structure  recognizes
that it would be “ ‘fundamentally unjust’ ” for a state agency 
to “ ‘share in damages for which it has provided no compen-
sation.’ ”  Id., at 288, n. 19. 

Today, however, the Court permits exactly that.  It holds