Document ID: ./input/supremecourt_opinions/opinions/21pdf/20-1263diff_868c.pdf
Page Number: 16

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

11 

Opinion of the Court 

it is far from clear that §§1396a(a)(25)(A) and (B) refer only 
to past expenses the State has already paid.  The relevant 
language—“pay[ment] for care and services available under 
the plan”—could just as readily refer to payment for medi-
cal care “available” in the future.  Regardless, even if this
language means what Gallardo says it does, Congress did 
not use this language to define the scope of an assignment
under §1396k(a)(1)(A), implying again that the provisions
should not be interpreted the same way.  See supra, at 7. 
fact  that 
This 
§1396k(a)(1)(A)  was  enacted  after  §§1396a(a)(25)(A)  and 
(B).  It would have been easy for Congress to use the exist-
ing  language  in  §§1396a(a)(25)(A)  and  (B)  to  define  the 
scope of the mandatory assignment.  But it did not.4 

is  strengthened  by  the 

implication 

Finally, Gallardo relies on two policy arguments for her 
preferred interpretation.  First, citing a footnote from Ahl-
born, she contends that it would be “ ‘absurd and fundamen-
tally unjust’ ” for a State to “ ‘share in damages for which it
has  provided  no  compensation.’ ”    547  U. S.,  at  288,  n. 19 
(quoting  Flanigan  v.  Department  of  Labor  and  Industry, 
123 Wash. 2d 418, 426, 869 P. 2d 14, 17 (1994)).  Although 
Ahlborn noted possible unfairness if States were given “ab-
solute priority” to collect from the entirety of a tort settle-
ment, 547 U. S., at 288, our holding there was dictated by 
the Medicaid Act’s “text,” not by our sense of fairness, id., 
at 280.  Had the text of the Medicaid Act authorized “abso-
lute priority,” Ahlborn would have been decided differently.
Second,  Gallardo  speculates  that  our  reading  of 
§1396k(a)(1)(A)  would  authorize  a  “lifetime  assignment” 
covering not only the rights an individual has while he is a 
Medicaid beneficiary but also any rights he acquires in the 
future when he is no longer a Medicaid beneficiary.  Brief 
—————— 

4 That Congress required States’ compliance with §1396k(a)(1)(A) via
a separate paragraph—§1396a(a)(45)—rather than subordinating it un-
der §1396a(a)(25), supports our conclusion that they need not be inter-
preted in lockstep.