Court Opinion

ID: 9489111
Source: CourtListenerOpinion
Date Created: 2023-08-05 13:06:02.301011+00
Date Added: 2024-06-11T17:53:19.652890
License: Public Domain

GINSBURG, Circuit Judge,
concurring:
I agree with the court’s dismissal of Mod-derno’s claim. The disparate treatment of which she complains is that between physical impairment on the one hand and mental impairment on the other. That disparity is permissible under § 504 of the Rehabilitation Act, 29 U.S.C. § 794, because it is unrelated to disability, defined as a substantial limitation upon one or more of a person’s major life activities, id. § 706(8)(B)(i).
I write separately because I believe that by resting its affirmance upon this unobjectionable point, the court misses the more general and more fundamental principle: only by providing less coverage to some or all persons who are currently disabled does an insurance plan contravene § 504. As a result of this oversight the court mistakenly suggests, albeit in dicta, that a plan might violate § 504 if it covered a non-disabling illness but not a disabling version of the same illness. See Court Op. at 1061.
*1066In this case the same insurance coverage was made available to all regardless of handicap; there is no indication and no claim that the benefits were only formally but not meaningfully available to the handicapped. See Alexander v. Choate, 469 U.S. 287, 302, 105 S.Ct. 712, 721, 83 L.Ed.2d 661 (1985) (disabled must “benefit meaningfully from the coverage they will receive”). Unless some coverage is denied to persons who currently have a disabling condition while at the same time granted to those who do not currently have a disabling condition, or denied to persons with a particular disability but not to persons with a different disability, there is no discrimination on account of disability. Equal coverage for all is non-discriminatory. That is the fundamental ground upon which Modderno’s claim fails.
True enough, some facially neutral coverage may lead to significantly disparate outcomes. In Alexander the Supreme Court refused to rule out a disparate impact claim. Id. at 299, 105 S.Ct. at 719. If it can be demonstrated that seemingly equal coverage necessarily and significantly favors the currently non-disabled over the currently disabled, and if the differences are so substantial as effectively to deny the disabled meaningful access to coverage, then perhaps a disparate impact claim can be made out.
In Alexander the Court approved a reduction in inpatient coverage that left “both handicapped and nonhandicapped Medicaid users with identical and effective hospital services fully available for their use, with both classes of users subject to the same durational limitation.” Id. at 302, 105 S.Ct. at 721. The Court went on to note that “[s]ection 504 does not require the State to alter ... the benefit being offered simply to meet the reality that the handicapped have greater medical needs.” Id. at 303,105 S.Ct. at 721. Further: “The [Rehabilitation] Act does not ... guarantee the handicapped equal results,” id. at 304, 105 S.Ct. at 722, nor is § 504 intended “to make major inroads on the States’ longstanding discretion to choose the proper mix of amount, scope, and duration limitations on services covered by state Medicaid,” id. at 307, 105 S.Ct. at 723. Indeed, “to require that the sort of broad-based distributive decision ... always be made in the way most favorable, or least disadvantageous, to the handicapped, even when the same benefit is meaningfully and equally offered to them, would be to impose a virtually unworkable requirement on state Medicaid workers.” Id. at 308, 105 S.Ct. at 724 (emphasis added).
With Alexander as our guide, it seems to me that § 504 does not invalidate an insurance plan merely because it covers a particular illness up to the point at which it becomes disabling, but not thereafter, nor because it excludes coverage of particular illnesses that are inherently disabling. As long as the Foreign Service Benefit Plan offers the same coverage to all insureds, regardless of disability, it cannot be said to discriminate on the basis of disability.