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

4 

GALLARDO v. MARSTILLER 

SOTOMAYOR, J., dissenting 

lien provision” permitting the State “to recover that portion 
of a settlement that represents payments for medical care.” 
Id., at 282, 284–285. 
  Importantly, the Ahlborn Court rejected the State’s claim
that it could seek reimbursement more broadly from the re-
mainder of the settlement funds.  It held that “the anti-lien 
provision applies” to bar a State’s assertion of a lien beyond
the portion of a settlement representing payments for med-
ical care.  Id., at 285; accord, Wos v. E. M. A., 568 U. S. 627, 
636 (2013).  As relevant to the case before it, the Ahlborn 
Court concluded that the State could not recover from por-
tions of a settlement representing compensation “for dam-
ages  distinct  from  medical  costs—like  pain  and  suffering,
lost wages, and loss of future earnings.”  547 U. S., at 272. 
The Court noted that it would be “unfair to the recipient” 
and “ ‘absurd’ ” for the State to “ ‘share in damages for which 
it has provided no compensation.’ ”  Id., at 288, and n. 19. 

II 

The  Court  summarizes  Florida’s  Medicaid  Third-Party 
Liability Act and the facts of petitioner Gianinna Gallardo’s 
case.  See ante, at 3–5.  The question presented is whether 
the exception to the anti-lien provision recognized in Ahl-
born  extends  to  permit  Florida  to  claim  the  share  of  Gal-
lardo’s settlement allocated for her future medical expenses
as  compensation  for  the  State’s  expenditures  for  her  past 
medical expenses.

Before answering that question, a note is in order about 
what is not in dispute.  Consider a hypothetical example in 
which Florida has spent $1,000 on a beneficiary’s medical
care, after which the beneficiary secures a $1,500 tort set-
tlement,  $200  of  which  is  allocated  for  those  already-in-
curred medical expenses, $500 of which is allocated for fu-
ture  medical  care,  and  the  remainder  of  which  ($800)
compensates for nonmedical expenses.  The parties agree,