Court Opinion

ID: 9730064
Source: CourtListenerOpinion
Date Created: 2023-08-26 15:00:00.057641+00
Date Added: 2024-06-11T18:26:03.763251
License: Public Domain

STATON, Judge,
dissenting.
The majority has allowed the Welfare Department to determine if one is able to defray the necessary expenses of one’s medical care by using standards from the Aid to Dependent Children Program when that very program considers those standards not to be suited for such a task. The majority has also circumvented the legislature by adding a restriction to the existing statutes. I respectfully dissent.
The majority concludes that Bradley was financially able to defray the necessary expenses of her medical, surgical, and hospital care because, according to Aid to Dependent Children Standards, her Black Lung benefits and Social Security benefits total more than a “subsistence” level. I can not agree with the majority because computing if Bradley surpasses a “subsistence” level of income does not determine if she is financially able to defray the necessary expenses of her expensive medical, surgical, and hospital care.
The Aid to Dependent Children Program recognizes that its basic eligibility requirements, which the Welfare Department used to determine that Bradley’s Black Lung and Social Security benefits exceeded a “subsistence” level, do not allow sufficient resources to cover the expenses of medical care, because they are not rationally related to a determination of ability to pay medical expenses; therefore, the Aid to Dependent Children Program has a separate standard to be applied when determining if a family qualifies for medical assistance due to an inability to pay for medical care. I would not allow a standard to be used to determine if one qualifies for medical assistance when the creator of that standard does not *77believe it to be rationally related to the determination of ability to pay for medical care.
If the Welfare Department had used the Aid to Dependent Children Program’s Medical Assistance Standard, IC 12-1 — 7—18.6, the Bradley family would qualify for medical assistance. I believe that this standard attempts to take into account the following considerations that the “subsistence” standard used by the Welfare Department did not: (1) While a family may be able to meet the usual expenses associated with a “subsistence” level of existence, this does not mean the family can afford to pay for unusual medical, surgical, and hospital care; (2) It is to the State’s advantage to have curable diseases, defects, or deformities cured in their early stages because (a) they are less expensive to cure in their early stages (b) the sooner the citizen is cured, the sooner he may be able to become an employed (productive) tax paying citizen.
Someone barely over a “subsistence” level of income is more likely to delay treatment until the time the State must pay the now more expensive medical cure; (3) Since family resources have to provide for the entire family, a reasonable amount of the resources above the usual family “subsistence” level should be reserved pro rata to meet other family needs including the illness of other members of the family. Neither standard considers the total amount of the medical, surgical, and hospital expenses of the other members of the family or the amount of time it will take a family to pay these expenses. . Common sense dictates that the total amount of expenses and the time required to pay them should be considered when one determines if someone is able to pay for their medical, surgical, and hospital care.
The majority states that IC 1971, 12-5-1 — 16 “can be interpreted to cover a situation where a change of circumstances in the future enables the patient to repay the Welfare Department.” The majority then circumvents the legislature by legislating a new restriction. This restriction states that IC 12-5-1-16 only applies when there are future changes of the patient’s financial circumstances. The legislature stated that repayment contracts could be executed whenever the Welfare Departments determined the patient could repay over a period of time all or part of the medical costs. These words must be construed in light of the factual and legal circumstances existing at the time of their enactment, not now. Rose v. State (1976), 168 Ind.App. 674, 345 N.E.2d 257, 260.
The majority, ever mindful that County Welfare Department budgets are presently decreasing, adds its restriction to the meaning of the statute so that patients, such as Bradley, who could repay at least part of her medical costs if given time, will not qualify. I do not believe the legislature intended such a narrow interpretation for IC 12-5-1 — 16 when it was passed in the early 1950’s. P.L. 144, Senate Enrolled Act No. 243 (1981) was created in response to our present circumstances. I can not agree to legislate a new restriction on IC 12-5-1-16 just before it is repealed on January 1, 1982 by proper legislative action. I believe people such as Bradley come within its terms and IC 12-5-1-1.
I would instruct the trial court to vacate its judgment and to enter judgment for the Trustees of Indiana University.