Document ID: ./input/supremecourt_opinions/opinions/22pdf/21-806_2dp3.pdf
Page Number: 33.0

Cite as:  599 U. S. ____ (2023) 

1 

THOMAS, J., dissenting 

SUPREME COURT OF THE UNITED STATES 

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No. 21–806 
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HEALTH AND HOSPITAL CORPORATION OF MARION 
COUNTY, ET AL., PETITIONERS v. IVANKA TALEVSKI, 
AS PERSONAL REPRESENTATIVE OF THE ESTATE 
OF GORGI TALEVSKI, DECEASED 

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

[June 8, 2023]

 JUSTICE THOMAS, dissenting. 
I  agree  with  JUSTICE  ALITO  that  the  Federal  Nursing
Home  Reform  Act  (FNHRA)  cannot  be  enforced  through 
Rev. Stat. §1979, 42 U. S. C. §1983, under Gonzaga Univ. v. 
Doe, 536 U. S. 273 (2002).  I write separately to highlight
another and more fundamental reason why FNHRA cannot 
be enforced under §1983.  Section 1983 provides a cause of 
action to redress only “the deprivation of any rights, privi-
leges, or immunities secured by the Constitution and laws.”
But  legislation  enacted  pursuant  to  Congress’  spending 
power, like FNHRA, does not “secure” rights by “law.”

For nearly all of our Nation’s history, it was understood 
that there is a fundamental difference between the exercise 
of Congress’ sovereign legislative powers, on the one hand, 
and the exercise of its power to spend money and to attach
conditions to the receipt of that money, on the other.  Only
the former sort of legislation, which imposes obligations on 
regulated parties with the force of law, directly secures by
law the rights corresponding to those obligations.  By con-
trast, an exercise of Congress’ spending power, whether it
comes from the so-called Spending Clause or elsewhere in
the Constitution, is no more than a disposition of funds.  As