Opinion ID: 2082423
Heading Depth: 1
Heading Rank: 3

Heading: The Medicaid System

Text: The Legislature established New York's Medicaid system in 1966 (L 1966, ch 256), the year after Congress created the federally funded Medicaid program ( see, Pub L 89-97, 79 US Stat 344). Under this complex scheme, the Federal government and States share the cost of providing Medicaid to certain categories of needy individuals. The shared program provides benefits to the disabled, the blind, the elderly, children, pregnant women, single-parent families and parents of children where there is a deprivation factor in the household ( see, 42 USC § 1396a [a]). To remain eligible for Federal matching funds, New York must conform its Medicaid program to evolving Federal standards ( see, 42 USC § 1396a [b]; Social Services Law § 363-a). If a State wants to extend Medicaid benefits to others, it is free to proceed at its own expense. New York has done so. It has provided non-federally subsidized Medicaid benefits to certain categories of individuals, including residents between the ages of 21 and 65 whose income and resources fall below a statutory standard of need and who are not otherwise entitled to federally subsidized Medicaid ( see, Social Services Law § 366 [1]; 18 NYCRR 360-3.3 [b]). Thus, New York State's Medicaid system has two components: one that is federally subsidized and one that the State funds entirely on its own. [3] New York had long provided State Medicaid to needy recipients without distinguishing between legal aliens and citizens. It ceased to do so, however, after Congress enacted the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Pub L 104-193, 110 US Stat 2105 [codified in scattered sections of 8 and 42 USC]) (PRWORA). Asserting that they have been unlawfully deprived of State Medicaid for which they would otherwise qualify, plaintiffs have brought this challenge.