ACA Federalism Litigation State by State

Federalism cases involving the ACA, and Medicaid maintenance of effort (Families First Act, sec. 6008) materials, and a law review article on the ACA and federalism


FLORIDA V. U.S., No. 3:10-cv-91 (N.D. Fla.)

US motion to dismiss, June 16, 2010


Florida opposition, August 6, 2010

Plaintiffs’ dism op

US reply, August 27, 2010

florida v us feds dism reply

Florida v. U.S., No. 3:10-cv-91 (N.D. Fla.), Order on Motion to Dismiss (Oct. 14, 2010)

motion to dismiss order

Plaintiffs’ summary judgment motion and memo, November 4, 2010

pltfs sj mo

pltfs sj memo

US summary judgment motion, statement of material facts, and memo, November 4, 2010

govt sj mo

govt sj statement of facts

govt sj ms

US answer to first amended complaint, November 4, 2010

Florida govt answer to 1st amended complaint

US opposition to plaintiffs’ summary judgment motion, November 23, 2010

Govt SJ op

Plaintiffs’ opposition to US summary judgment motion, November 23, 2010

Pltfs’ SJ op

Pltfs’ SJ addl evidence

Pltfs’ response to govt statement of facts

Plaintiffs’ reply supporting summary judgment, December 6, 2010

Pltfs’ SJ reply

US reply supporting summary judgment, December 6, 2010

Govt’s sj reply

Florida v. U.S., No. 3:10-cv-91 (N.D. Fla.), Order Granting Summary Judgment (Jan. 31, 2011)

Florida v. U.S., Nos. 11-11021/11067 (11th Cir.), Opinion (Aug. 12, 2011)

National Fed. of Indep. Business v. Sebelius, Nos. [[tel:11-393/398|11-393/398]]/400 (U.S., June 28, 2012)


Conway Medical Center v. Becerra, No. 1:21-cv-1250 (D. D.C., filed May 6, 2021)




Alaska Legislative Council v. Walker, No. 3AN-15-09208CI (Alaska Superior Court), Transcript of Decision (Aug. 28, 2015)

Alaska Legislative Council v. Walker, No. 3AN-15-09208CI (Alaska Superior Court), Summary Judgment Decision and Order (March 1, 2016)


Biggs v. Brewer, No. CV-14-0132-PR (Arizona), Opinion (Dec. 31, 2014)

Biggs v. Brewer, No. CV 2013-011699 (Maricopa Co. Superior Court), Opinion (Aug. 27, 2015)

Biggs v. Betlach, No. 1 CA-CV 15-0743 (Arizona App.), Opinion (March 16, 2017)

Biggs v. Betlach, No. CV-17-0130-PR (Arizona), Opinion (November 17, 2017)

Rivera v. Kent, No. A147534 (Cal. Ct. of Appeal, 1st District, June 27, 2019)
Rivera v. Kent, No. S257304 (Cal. Supreme Court, July 8, 2020)
07/08/2020 Transferred to CA 1/4 after grant of review In light of respondent’s concession of both issues on which we granted review, there is no controversy remaining for the court to decide. Respondent acknowledges that “[t]he existence of a separate performance standard does not categorically preclude mandamus relief in a case alleging a violation of the timeliness standards under state and federal law. Performance and timeliness standards are separate requirements.” Respondent also recognizes that in “a situation involving statewide problems in making eligibility determinations . . . it was proper for plaintiffs to seek relief from the Department rather than the counties.” Accordingly, the matter is transferred to the Court of Appeal, First Appellate District, Division Four, for further proceedings consistent with respondent’s concessions. (Cal. Rules of Court, rule 8.528, subd. (d).) On the court’s own motion, the Reporter of Decisions is directed not to publish in the Official Appellate Reports the opinion in the above-entitled appeal filed June 27, 2019 which appears at 37 Cal.App.5th 529. (Cal. Const., art. VI, section 14; Cal. Rules of Court, rule 8.1125, subd. (c)(2).) The Court of Appeal is also directed to award to petitioners the costs of obtaining review in this court (Cal. Rules of Court, rules 8.544, 8.278, subd. (c)), and, under the circumstances of this litigation also consider whether to award attorney’s fees, should petitioners so move.

Votes: Cantil-Sakauye, C.J., Chin, Corrigan, Liu, Cuéllar, Kruger and Groban, JJ.


Petition for Review in Regan v. Denney, Idaho Supreme Court No. 46545-2018

Petition for Review

Attorney General opinion, November 7, 2017


Idaho Supreme Court, #46545, oral argument, January 29, 2019

Regan v. Denney, #46545, opinion, February 5, 2019



Adams v. Comm. of Kentucky, No. 13-CI-605 (Franklin, Ky. Co. Circuit Court, Division 1, Sept. 3, 2013)


Mayhew v. Burwell, No. 14-1300 (1st Cir.), Opinion (Nov. 17, 2014)

Maine Equal Justice Partners v. Hamilton, No. CV-18-___ (Kennebec Co. Superior Court)

Merits Brief

Motion to Expedite

Order, June 4, 2018

Order, August 23, 2018

Submissions to CMS package (from the Maine Supreme Judicial Court website, September 4, 2018)









Order, November 21, 2018

Ord 80C Appeal 11-21-18


Cady v. Ashcroft, Nos. WD83823/WD83824, (Mo. App., June 8, 2020)

Opinion_WD83823 and WD83824

Doyle v. Tidball, No. 21AC-CC0086 (Cole Co. Circuit Court, June 23, 2021)


Doyle v. Tidball, SC99185 (Missouri Supreme Court), set for oral argument, July 13, 2021

Doyle v. Tidball opinion, July 22, 2021



Christensen v. Gale, No. CI 18-2305 CI-(Lancaster County District Court, August 28, 2018)

2018_08_28_13_34_15 (1)

Christensen v. Gale, 301 Neb. 19 (Nebraska, Sept. 12, 2018)


Amicus briefing in Gresham v. Azar, No. 20-37

Nebraska amicus brief, January 26, 2021

20210126160303362_Azar – 2021.01.26 NE Amicus Brief FINAL

Nebraska Appleseed amicus brief, February 23, 2021

20210223141045362_Appleseed Amicus PDFA

Etheredge v. Nebraska Dep’t of Health and Human Services (Lancaster Co. District Court, filed Feb. 25, 2021)


Nebraska Appleseed press release, Feb. 26, 2021

RELEASE: Nebraska Appleseed Files Suit to Ensure Access to Benefits in Medicaid Expansion


Berger v. Burwell, No. 5:17-cv-25 (E.D. N.C.), TRO (January 14, 2017)

Order, January 27, 2017

US op to PI/motion to dismiss, April 7, 2017

Pltf wdwl PI motion, April 17, 2017

Pltf op US mo dism, 4/28/2017

US reply supporting mo to dismiss, 5/12/2017

Voluntary dismissal, 7/20/2017

Berger voluntary dismissal

In re Initiative Measure No. 65, NO. 2020-IA-01199-SCT (Mississippi Supreme Court, May 14, 2021)


Ohio ex rel Cleveland Right to Life v. State of Ohio Controlling Board, 138 Ohio St.3d 57 (Dec. 20, 2013)


State of Tennessee by and through Tennessee General Assembly v. U.S. Dep’t of State, No. 1:17cv01040 (W.D. Tenn.)


Sixth Circuit opinion, July 24, 2019

20191219092833212_Tennessee_6th Cir Opinion

Order denying rehearing en banc, October 16, 2019

20191219092841306_CA6_10 16 2019 Order denying rehearing en banc

Petition for certiorari, No. 19-1137, March 13, 2020

20200313170336928_TN cert petition_3 13 2020_final

US waiver of right to respond, April 13, 2020

20200413192043038_Waiver Letter 19-1137

Center for Immigration Studies amicus, April 15, 2020

20200415122101688_200407a Amicus Brief for efiling

Eagle Forum amicus, April 15, 2020

20200415110002285_19-1137 Amicus Brief Eagle Forum

Immigration Reform Law Institute amicus, April 16, 2020

20200416153018159_19-1137 IRLI Tenn Refugee Pet Amicus

Request for response, May 12, 2020

[Most recent deadline, 8/14/2020]

A.M.C. v. Smith, No. 3:20-cv-240 (M.D. Tenn., filed March 19, 2020)


AMC complaint


Defendant’s motion for leave to file supplemental brief, with exhibits including CMS certification, January 19, 2021

AMC def mo leave file supplemental 1 19 21

Defendant’s notice of change in 6008 policy, January 19, 2021

AMC CMS notice re policy change 1 19 2021

Order denying pending motions w/o prejudice and setting further discovery, February 19, 2021

amc order denying motions w o prejudice


2017 SB 884 (as introduced 12/3/18), see sec. 26


2017 SB 884 (as presented to the Governor 12/13/18), see sec. 26


2017 SB 886 (as introduced 12/3/18), see secs. 10 and 14


2017 SB 886 (as presented to the Governor 12/13/18), see secs. 10 and 14


2017 SB 887 (as introduced 12/3/18)


Litigation statutes as amended December 2018

Wisconsin litigation statutes as amended December 2018

Memo from Legislative Reference Bureau to Majority Leader Fitzgerald, 1/23/19


Letter from AG Kaul to Gov. Evers, 1/23/19


Letter from AG Kaul to committee chairs, 1/24/19


League of Women Voters v. Knudson, Case No. 19 CV 84 (Dane Co. Circuit Court, 3/21/19)


Wisconsin Court of Appeals stay order, 3/27/19


Wisconsin Court of Appeals order restricting enforcement of stay, 4/9/19


Wisconsin Supreme Court order, 4/30/19


Wisconsin Supreme Court opinion, 6/21/19


See also: San Francisco v. Barr, No. 18-17308

Opinion, July 13, 2020

9C SF v Barr opinion

Cert petition, No. 20-666

20201113170206407_20-___ – Barr v San Francisco Cert Petition

See also: New York v. Nos. 19-267 and 19-275

Opinion, Feb. 26, 2020

2C opinion 2 26 20

Rehearing en banc denial, July 13, 2020

2C rheb denial

New York State cert petition, No. 20-795

20201207185617048_No. 20-__ PetitionForAWritOfCertiorari NY v DOJ

New York City cert petition, No. 20-796

20201207174051249_Byrne JAG – cert petition – centered

General Assembly Tennessee petition for cert

20200313170336928_TN cert petition_3 13 2020_final

Notre Dame Law Review symposium on state standing











Coronavirus federalism materials

Letter to Secretary Azar from Democratic AGs, April 3, 2020

CA NC COVID-19 healthcare exchange letter plus IA


Families First Coronavirus Response Act, Pub. L. 116-127


Section 6008


Section 6008, highlighting “such benefits”

6008 — such benefits

CMS FAQs, April 13, 2020


CMS FAQs, June 30, 2020


National Health Law Program, The Maintenance of Effort Provision Protects Services, August 10, 2020


CMS and other agencies, Additional Policy and Regulatory Revisions in Response to the COVID–19 Public Health Emergency, 85 Fed. Reg. 71,142 (Nov. 6, 2020)


CMS fact sheet and power point



Families USA analysis, November 17, 2020


Stimulus bill/omnibus bill, as released Dec. 21, 2020


Explanation of the Labor/HHS omnibus bill provisions, released Dec. 21, 2020


Explanation of the COVID-19 stimulus provisions, released Dec. 21, 2020

Summary of H.R. 133 Coronavirus Relief Provisions

Abbe R. Gluck, Intrastatutory Federalism and Statutory Interpretation: State Implementation of Federal Law in Health Reform and Beyond, 121 Yale Law Journal 534 (2011)


What is more, the Supreme Court has suggested that the federalism clear-statement rule is of limited applicability when a federal regulatory regime is enforced through a statutory cooperative-federalism framework, as Section 7411(d) is. See AT&T Corp. v. Iowa Util. Board, 525 U.S. 366, 378 n.6 (1999) (noting appeals to States’ rights as “most peculiar” in the context of “a federal program administered by 50 independent state agencies”); see also Alaska Dep’t of Env’t Conservation v. EPA, 540 U.S. 461 (2004) (declining to adopt dissent’s proposed clear-statement rule for federal constraints on state implementation decisions in cooperative-federalism program). See generally Abbe Gluck, Intrastatutory Federalism and Statutory Interpretation: State Implementation of Federal Law in Health Reform and Beyond, 121 YALE L.J. 534, 555–556 (2011).

American Lung Ass’n v. EPA, Nos. 19-1140 et al. (D.C. Cir., Jan. 19, 2021), slip op. at 94