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The Equal Access Illusion: A Growing Majority of Federal Courts Erroneously Foreclose Private Enforcement of § 1396a(a)(30) of the Medicaid Act Using 42 U.S.C. § 1983

I. INTRODUCTION

Medicaid is a social welfare program that Congress established under the Medicaid Act, which is Title XIX of the Social Security Act of 1965.1 Like most grant-in-aid programs,2 Congress enacted the Medicaid Act pursuant to its spending powers, which are authorized under the United States Constitution (the "Constitution").3 While states are not required to participate in Medicaid, once a state enrolls in the program it must agree to provide federally prescribed services.4 If a state fails to comply with the requirements of the Medicaid Act, the federal government has an administrative remedy available, though it is rarely used and is generally considered to be ineffective.5 ...

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