Argument of Speaker
Mr. Speaker: The opinion of the court No. 00-952, Wisconsin Department of Health and Family Services versus Blummer will be announced by Justice Ginsburg.
Argument of Justice Ginsburg
Mr. Ginsburg: This case concerns the spousal impoverishment provisions of the Medicare Catastrophic Coverage Act of 1988, a complex set of instructions made part of the Federal Medicaid Statute.
The provisions at issue concerned couples who must live apart when one spouse is confined in a care institution usually a nursing home and the other spouse remains at home in the community.
The Act allows the spouse living at home called the community spouse to reserve certain income and assets to meet the minimum monthly needs he or she will have when the other spouse called the institutionalized spouse becomes eligible for Medicaid.
Essential to this controversy is the amount of assets the Act shelters from free eligibility diminution called the community spouse resource allowance.
Either spouse may seek an increase in the standard resource allowance.
To gain an increase, the applicant must show at a State-administered hearing that the community spouse will otherwise fall short of the statutorily defined minimum level of income on which to live after the institutionalized spouse gains Medicaid eligibility.
In determining whether the community spouse may be granted a higher resource allowance in other words, whether he or she may shelter additional assets Wisconsin, like most States, uses an income-first method.
Under that method, the State considers first whether potential post eligibility income transfers from the institutionalized spouse, transfers the Act expressly permits, will unable the community spouse to meet monthly needs.
Respondent, Irene Blummer who lives in a nursing home applied for Medicaid assistance from petitioner, Wisconsin Department of Health and Family Services.
Her application was denied because the Blummer’s assets have not yet been reduced to an amount low enough to render Irene Medicaid eligible.
Irene thereafter sought a hearing to increase the community spouse resources allowance reserved for her husband per net.
The hearing examiner have found no increase warranted.
Because Irene could transfer some of her income to Burnett once she became Medicaid eligible, the examiner explained, Wisconsin’s income-first method bought a larger resource allowance for Burnett.
The Blummers were therefore obliged to spend resources.
Irene preferred to shield for Burnett before Wisconsin will declare Irene Medicaid eligible.
In State Court, Irene challenged Wisconsin’s income-first Method as inconsistent with the Federal Acts Provision an upward revision of the resource allowance.
The Wisconsin Court of Appeals ruled in her favor.
We now reversed that Court's judgment.
For reasons stated at some length in the opinion, we conclude that neither the Act's text nor its structure forbids the income-first method Wisconsin follows.
Consistent with the position advanced by the Secretary of Health and Human Services, we hold Wisconsin’s method a permissible interpretation of the Act.
Justice Stevens has filed a dissenting opinion in which Justice O’Connor and Justice Scalia join.
