Access to Justice

Wos (Delia) v. E.M.A.

Delia v. E.M.A., later renamed Wos v. E.M.A., was a case that raised important questions about the preemptive force of the Medicaid statute and the Supremacy Clause of the U.S. Constitution.

Case Summary

On December 17, 2012, Constitutional Accountability Center, joined by AARP, filed a brief in the U.S. Supreme Court in support of the respondents in Delia v. E.M.A., later renamed Wos v. E.M.A., a case that raised important questions about the preemptive force of the Medicaid statute and the Supremacy Clause of the U.S. Constitution.

The federal Medicaid statute includes a provision limiting a participating state from imposing a lien on the property of a Medicaid beneficiary. The state of North Carolina, following a state statute that is in apparent conflict with this provision, asserted a statutory lien on settlement proceeds earned by “E.M.A.,” a young girl from North Carolina whose guardian brought this case on her behalf.

The brief filed by CAC and AARP directly addressed an amici curiae brief filed by the state of Texas, joined by several other states, arguing that Medicaid has no preemptive force. Texas asserted that states are free to disregard Medicaid directives and then take reduced federal funds, if the federal government chooses to “turn off the spigot.”

In our brief, we demonstrated that Texas’s position is contrary to the text and history of the Constitution, 200 years of precedent, and the language of the Medicaid statute. The brief begins by showing that the intention of the Framers at the Constitutional Convention in 1787 was to establish the supremacy of all federal laws, and to permit private enforcement of the supremacy of federal law. Decisions of the early Supreme Court, written by Chief Justice Marshall, expressed the understanding of the Founding Generation that every conflicting state law would yield to federal law. More recently, Justice Kennedy has repeatedly emphasized the importance of preemption, including in the context of litigation by individuals to enforce the Medicaid statute. Texas’s argument that Medicaid has no preemptive force is contrary to the text of the statute and Supreme Court jurisprudence permitting private enforcement of Medicaid.

The Supreme Court heard oral argument in Delia on January 8, 2013.

On March 20, 2013, in a 6-3 ruling, the Court held that federal Medicaid law did indeed pre-empt North Carolina’s statute, in a victory for young “E.M.A” and for the 62 million other Americans who depend on Medicaid for access to health care.

For further commentary on the Court’s ruling see Rochelle Bobroff and Simon Lazarus’ post, “Victory for Enforcement of Medicaid in Wos v. E.M.A. See also Simon Lazarus’ article in the National Law Journal.

Case Timeline

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