Consejo De Salud De P.R., Inc. v. United States

450 F.Supp.3d 103

CONSEJO DE SALUD DE PUERTO RICO, INC., et al., Plaintiff,

v.UNITED STATES of America, et al., Defendants.

CIVIL NO. 18-1045 (GAG)

United States District Court, D. Puerto Rico.

Signed March 30, 2020

Ignacio Fernandez-De-Lahongrais, Fernandez & Alcaraz, PSC, San Juan, PR, for Plaintiff.

Cesar A. Lopez-Morales, Joseph E. Borson, Daniel Riess, United States Department of Justice, Washington, DC, for Defendants.

OPINION & ORDER

GUSTAVO A. GELPI, Chief United States District Judge

The Commonwealth of Puerto Rico once more brings a Spending Clause challenge to the discriminatory territorial Medicaid cap imposed by Congress. A decade ago the Court held that the Spending Clause applied to the territory. Consejo de Salud Playa de Ponce v. Rullán, 586 F. Supp. 2d 22 (D.P.R. 2008) ; Consejo de Salud Playa Ponce v. Rullán, 593 F. Supp. 2d 386 (D.P.R. 2009). However, before the Court could effectively entertain the merits of whether the federal statute violated the constitutional provision, the Commonwealth withdrew its claim. This, in light of the fact that in 2009 Congress granted additional territorial Medicaid monies. Consejo de Salud Playa de Ponce v. Sec'y of Health of Puerto Rico, 705 F. Supp. 2d 163 (D.P.R. 2010).

As amply discussed in the Court's earlier opinions, the Commonwealth receives but a fraction of what the poorest State receives in Medicaid funding. To add insult to injury, the Commonwealth which is bankrupt, under the Medicaid statute is forced to make "wraparound" payments to its federally qualified health centers at a rate preposterously multiplicative to that of States. Following the passage of Hurricane María, and now, in light of the COVID-19 pandemic, Congress has provided the much-needed increased Medicaid funding in order to assist the more than three million United States citizens living in the territory. Notwithstanding, the Commonwealth posits that these congressional assignments are temporary, therefore, the Spending Clause violation remains.

The parties devote much of their arguments to the constitutional status of Puerto Rico vis-à-vis the United States. It is unnecessary to address the same at this time. The Commonwealth, whether incorporated or unincorporated is nonetheless a territory. It is not the fifty first member of the Union within the constitutional definition of the term "State." Cf. United States v Maldonado-Burgos, 844 F. 3d 339 (1st Cir. 2018) (distinguishing commonwealth status from a legislative intent perspective). As such, the Commonwealth's assignment of Medicaid funds is the sole prerogative of Congress. That is, because constitutionally speaking, Congress is not legislating for one of the States, but rather, as to a territory.

Consequently, the United States' Motion for Summary Judgment (Docket No. 177) is GRANTED , while the Commonwealth's Motion for Summary Judgment (Docket No. 184) is DENIED . Judgment...