Herweg v. Ray, 455 U.S. 265 (1982)

Herweg v. Ray

No. 80-60

Argued January 13, 1982
Decided February 23, 1982
455 U.S. 265

CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR

THE EIGHTH CIRCUIT

Syllabus

Section 1902(a)(17)(D) of the Social Security Act (Act) provides that, in calculating benefits, state Medicaid plans must not

take into account the financial responsibility of any individual for any applicant or recipient under the plan unless such applicant or recipient is such individual’s spouse.

Section 1902(a)(17)(B) provides that participating States must grant benefits to eligible individuals

taking into account only such income and resources as are, as determined in accordance with standards prescribed by the Secretary [of Health and Human Services (HHS)], available to the applicant or recipient.

Section 1902(a)(10)(A) requires States that have not exercised the so-called § 209(b) option to provide Medicaid assistance to all recipients of benefits under the Supplemental Security Income for the Aged, Blind, and Disabled (SSI) program. A federal regulation governing the "optional categorically needy" provides that, if only one spouse is eligible for Medicaid, the States must "deem" income of the other spouse, i.e., consider the latter’s income as "available" to the Medicaid applicant, for one month after the spouses cease to live together, following which period only the income actually contributed may be considered. After petitioner wife, as a result of cerebral hemorrhages, was placed in a long-term care facility in Iowa, which has not exercised the § 209(b) option, her petitioner husband applied for Medicaid assistance on her behalf. She is part of the optional categorically needy, since she is eligible for, but does not receive, SSI benefits. Iowa, in calculating the wife’s Medicaid benefits, "deemed" or attributed income earned by the husband to the wife in a manner inconsistent with the federal regulation. Petitioners then filed suit in Federal District Court, challenging Iowa’s "deeming" of the husband’s income. After certifying a class of plaintiffs which included SSI recipients as well as the optional categorically needy, the District Court held that § 1902(a)(17) required Iowa’s procedures to

provide for a factual determination in each instance of the amount of the spouse’s income which is in fact reasonably available for the support of the institutionalized spouse,

and that the federal time limitation regulation was inconsistent with § 1902(a)(17), because it disabled the States in certain instances from considering the spouse’s income as available to the applicant. In response to this order, Iowa adopted a procedure for making individualized factual determinations of the amount of income available to an institutionalized spouse, and the District Court approved the plan. On petitioners’ appeal, the Court of Appeals affirmed.

Held:

1. With regard to SSI recipients, the District Court’s order conflicts with § 1902(a)(10)(A) of the Act, because it permits Iowa to deny Medicaid benefits to SSI recipients. To the extent that the order forbids "deeming" under any circumstances, it conflicts with the holding in Schweiker v. Gray Panthers, 453 U.S. 34, that Congress intended to permit a state Medicaid plan to deem the income from the applicant’s spouse as part of the available income that the state plan may consider in determining eligibility. Pp. 272-273.

2. Section 1902(a)(17)(D) does not preclude the Secretary of HHS from promulgating regulations that impose time limitations upon the States’ ability to "deem" income between spouses who do not share the same household. In imposing such time limitations, the Secretary has done nothing more than define what income is "available," pursuant to § 1902(a)(17)(B). There is nothing in § 1902(a)(17)(D) that precludes the Secretary from imposing these limitations, or that either disables him from defining the term "available" in circumstances where the applicant and spouse no longer live together or gives the States authority to "deem" income unimpeded by the Secretary’s broad authority under § 1902(a)(17)(B) to determine what income should be considered available to the Medicaid applicant. The Secretary has not exceeded his authority in promulgating the time limitation regulation applicable in this case, and such regulation is neither arbitrary nor capricious. Pp. 273-278.

619 F.2d 1265, reversed and remanded.

REHNQUIST, J., delivered the opinion of the Court, in which BRENNAN, WHITE, MARSHALL, BLACKMUN, POWELL, and O’CONNOR, JJ., joined. STEVENS, J., filed an opinion concurring in part, post, p. 278. BURGER, C.J., filed a dissenting opinion, post, p. 279.