LYNN NEARY, Host:
It's the first Monday in October, and in Washington, that phrase has a special meaning. It's the opening of a new Supreme Court term. While last year's docket was a relative snoozer, this one is what Variety might call boffo - with major cases on the docket and more wending their way to the Court.
RENEE MONTAGNE, Host:
Today's curtain-raiser is the medical care law you never heard of, but it nonetheless has huge implications for states desperately short of cash, and people desperate for health care. NPR Legal Affairs correspondent Nina Totenberg reports.
NINA TOTENBERG: When California went ahead with the cuts anyway, hospitals, doctors, and patients sued to stop them. Dr. Ruth Haskins, an obstetrician-gynecologist who practices in southern California, has 4500 patients, about 15 percent of them Medicaid. She and other doctors worry they'll simply have to stop taking these patients.
RUTH HASKINS: We have to have a quota already, because the reimbursement is just too low to meet my overhead.
TOTENBERG: The state, backed by the Obama administration, contends that health care providers and their patients have no right to sue to enforce the Medicaid law. California solicitor general, Manuel Medeiros, says this is a contract dispute between the U.S. and the state, and the health care providers don't get to horn in on that dispute by taking the state to court.
MANUEL MEDEIROS: There was no expectation that we were going to have to be administering this multibillion dollar program by ad hoc litigation, where courts can substitute their individual judgment for the views of an expert administrative agency that has worked out the problems with the state administrative agency, balancing often competing state and federal interests and policy objectives.
TOTENBERG: Representing the health care providers, Lawyer Carter Phillips counters that if California had in fact shown how it was balancing competing interests, there would have been no case, but, he maintains, it didn't do that.
CARTER PHILLIPS: California has a budget problem and that is all that animated California's actions in this case. There was no effort made to determine whether or not these cuts would have any impact on services, but what California just said is look, we want to save money, we're going to do it this way, we're done.
TOTENBERG: California Solicitor General Medeiros doesn't entirely dispute that.
MEDEIROS: These are very peculiar times. The states and the federal government are operating under a very severe fiscal crisis, and everybody's trying to manage their financials as best they can.
TOTENBERG: Nina Totenberg, NPR News, Washington.
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