476
Syllabus
alized spouse to the community spouse through the CSMIA. Mindful that spouses may be expected to support each other, see, e. g., Schweiker v. Gray Panthers, 453 U. S. 34, 45, the Court is satisfied that a State reasonably interprets the MCCA by anticipating the CSMIA in the (e)(2)(C) hearing. This conclusion is bolstered by a further consideration: A fair hearing is not limited to a CSRA redetermination, but may also be used to adjust the CSMIA itself, § 1396r-5(e)(2)(A)(i); therefore, it cannot be concluded that the States are barred from taking account of the potential CSMIA in the hearing to increase the CSRA. Pp. 489-495.
(b) Because the parties have not also disputed the permissibility of the resources-first approach, this Court does not definitively resolve that matter. The Court notes, however, that the leeway for state choices urged by Wisconsin and the United States is characteristic of the Medicaid statute, which is designed to advance cooperative federalism. See Harris v. McRae, 448 U. S. 297, 308. When interpreting other statutes so structured, the Court has left a range of permissible choices to the States, at least where the superintending federal agency has concluded that such latitude is consistent with the statute's aims. See, e. g., Batterton v. Francis, 432 U. S. 416, 429-431. The Secretary, who possesses authority to prescribe standards relevant here, § 1396a(a)(17), has proposed a rule explicitly recognizing that the MCCA permits both the income-first and resources-first methods. That position statement warrants respectful consideration. Cf., e. g., Gray Panthers, 453 U. S., at 43-44. The MCCA affords the States large discretion regarding two related variables: the level of the MMMNA, § 1396r-5(d)(3), and the amount of assets the couple is permitted to retain, § 1396r-5(f)(2)(A). Nothing in the Act indicates that similar latitude is inappropriate with respect to the application of § 1396r-5(e)(2)(C). Eliminating a State's discretion to choose income-first would hinder the State's efforts to strike its own balance in implementing the Act. Lukhard v. Reed, 481 U. S. 368, 383. States that currently allocate limited funds through income-first would have little choice but to offset the greater expense of the resources-first method by reducing the MMMNA or the standard CSRA. That would benefit the relatively few applicant couples who possess significant resources, while offering nothing to, and perhaps disadvantaging, couples who lack substantial assets. Nothing in the Act contradicts the Secretary's conclusion that such a result is unnecessary and unwarranted. Pp. 495-498.
2000 WI App. 150, 237 Wis. 2d 810, 615 N. W. 2d 647, reversed and remanded.
Page: Index Previous 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 NextLast modified: October 4, 2007