Martina Brendel


Following the Supreme Court's 2002 decision in Gonzaga University v. Doe, several circuit courts of appeal have disallowed enforcement of key Medicaid provisions under § 1983. Notably, courts have placed no similar restrictions on the enforceability of these provisions under the Supremacy Clause. This article discusses Lankford v. Sherman and Independent Living Center v. Shewry, two recent appellate decisions in which plaintiffs succeeded in preventing Medicaid cuts under a preemption theory. It then addresses the limits of the Supremacy Clause, which applies to a narrower range of state action than § 1983. It argues that Medicaid reimbursement rates are "laws" within the meaning of the Supremacy Clause and, therefore, should be preempted by Medicaid's "equal access" provision if they are insufficient to attract providers into the Medicaid system.