Medicaid Agency's Residency Requirement Violates U.S. Constitution

A U.S. district court holds that requiring a Medicaid applicant to reside in-state for a period of time before her benefits are determined is a violation of her fundamental right to interstate travel as guaranteed under the U.S. Constitution. Duffy, et al., v. Meconi, et al. (Del., C.A., No. 05-127, Sept. 11, 2007).

Marianne Duffy, a 33-year-old Medicaid beneficiary, had resided in North Carolina since 1994. Ms. Duffy suffers from "developmental disabilities including blindness, seizures, autism, and mental retardation," which require her to live in an intermediate care facility for mental retardation (ICF/MR). In 2001, Ms. Duffy's parents moved from North Carolina to Delaware. After their move, the Duffys decided to relocate their daughter to Delaware and attempted to obtain Medicaid benefits through Delaware's program.

Delaware's Division of Developmental Disabilities Services determined that Ms. Duffy was not a resident of Delaware, and therefore not entitled to Delaware's Medicaid benefits. That finding, in combination with Ms. Duffy's inability to privately guarantee payment for a facility, had effectively prevented Ms. Duffy's enrollment in an ICF/MR facility in Delaware.

Ms. Duffy sued, alleging that Delaware's refusal to award her residential placement and services restrained her fundamental right to interstate travel and thus violated the Constitution's Privileges and Immunities Clause of Article IV, the Privileges and Immunities Clause of the Fourteenth Amendment and, the Equal Protection Clause of the Fourteenth Amendment.

The District Court of Delaware grants Ms. Duffy's motion for summary judgment, holding that the state's requirement of Ms. Duffy to first move to Delaware, at her own expense, before they will determine her Medicaid eligibility is effectively a veiled durational residency requirement, which is unconstitutional. Delaware must process Ms. Duffy's application for Medicaid benefits before she is physically present in the state.