Document ID: ./input/supremecourt_opinions/opinions/21pdf/20-1263diff_868c.pdf
Page Number: 24.0

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

7 

SOTOMAYOR, J., dissenting 

plan.”  Ibid.  It would be bizarre for Congress to mandate a
more  far-reaching  assignment  of  a  beneficiary’s  right  to
payment for all medical support, paid or unpaid, but limit
the beneficiary’s duty to cooperate only to services paid.  Fi-
nally, another provision of the Act directs each State to pass
laws requiring insurers to “accept . . . the assignment to the
State  of  any  right  of  an  individual  or  other  entity  to  pay-
ment . . . for an item or service for which payment has been
made  under  the  State  plan.”  §1396a(a)(25)(I)(ii).  In  this 
insurer  acceptance  provision,  Congress  described  the  as-
signment  provision’s  mandate  as  specific  to  third-party 
payments  for  services  the  State  plan  has  funded.    Taken 
together, these textual indicators establish that the assign-
ment provision reaches only a third party’s liability for ser-
vices made available by Medicaid, not liability for services
for which Medicaid has not paid and may never pay.

The second tool Congress enacted to implement the third-
party  liability  provision  is  the  acquisition  provision,
§1396a(a)(25)(H).  A 1990 General Accounting Office report 
found that some health insurers were “thwart[ing]” the as-
signment provision by “refusing to pay [States] for any of
several reasons,” including by declining to recognize Medi-
caid assignments or by insisting that such assignments con-
flicted  with  their  insurance  contracts.    Medicaid:  Legisla-
tion Needed to Improve Collections From Private Insurers 
5  (GAO/HRD–91–25,  Nov.).    Congress  addressed  this  in
1993 by directing each State to enact laws under which the
State automatically acquires a beneficiary’s rights to third-
party  payments  specifically  “for  health  care  items  or  ser-
vices furnished” to the beneficiary, without the need for sep-
arate assignments.  §1396a(a)(25)(H).  The text of this ac-
quisition  provision,  too,  clearly  restricts  a  State’s 
acquisition to the portion of a third-party payment pertain-
ing  to  “health  care  items  or  services”  for  which  “payment
has been made under the State plan” and does not extend