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Medina v. Planned Parenthood South Atlantic, 606 U.S. 357 (2025)
Lucas Reed*
I. Introduction
Mark Twain once observed that “the difference between the almost right word and the right word is really a large matter—’tis the difference between the lightning-bug and the lightning.”[1] Medina v. Planned Parenthood South Atlantic is a case about exactly that difference, finding that Congress must use explicit rights-creating language to confer enforceable rights.[2] In a 6-3 ruling, the Supreme Court held that Medicaid beneficiaries cannot sue state officials under 42 U.S.C. § 1983 to enforce the statute’s “any-qualified-provider” provision.[3] The decision was immediately controversial: critics warned that the ruling left vulnerable beneficiaries without any meaningful enforcement mechanism.[4]
This Note argues that Medina provided necessary clarification of the standards governing § 1983 enforcement of spending power statutes. By demanding unmistakable textual clarity before recognizing privately enforceable rights in spending power legislation, the Court honored the constitutional logic that states accepting federal funds are entitled to know, from the statutory text itself, which conditions expose them to private litigation. And contrary to its critics, Medina does not close courthouse doors; it tells Congress exactly how to open them.
Part II of this Note examines the factual background and procedural posture of Medina. Part III traces the evolution of § 1983 enforcement for spending power statutes from Pennhurst through Talevski. Part IV analyzes the Court’s decision and the competing opinions. Part V sets out the affirmative case for Medina’s approach, arguing that the Gonzaga/Talevski/Medina line reflects a coherent structural principle and offers a workable, predictable standard for lower courts. Part VI surveys lower court applications of Medina, examining how seemingly minor differences in statutory language determine whether a right is being conferred to a beneficiary—discerning, in other words, the lightning bugs from the lightning.
II. Facts and Holding
Planned Parenthood South Atlantic (“PPSAT”) administers two clinics in South Carolina, offering comprehensive healthcare services regardless of their Medicaid enrollment status.[5] In July 2018, South Carolina determined that PPSAT could no longer participate in the state’s Medicaid program, citing a state law prohibiting the use of public funds for abortion.[6] Julie Edwards, a Medicaid beneficiary who had positive experiences receiving gynecological care at PPSAT, filed suit alongside the organization under § 1983, arguing that the State’s exclusion violated the Medicaid Act’s any-qualified-provider provision.[7]
The any-qualified-provider provision, codified at 42 U.S.C. § 1396a(a)(23)(A), requires that state Medicaid plans “provide that . . . any individual eligible for medical assistance . . . may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required . . . who undertakes to provide him such services.”[8] Congress enacted this provision in 1967 to prevent states from steering Medicaid beneficiaries to state-preferred providers.[9]
The District Court granted summary judgment to the plaintiffs and entered a permanent injunction preventing South Carolina from excluding PPSAT from its Medicaid program.[10] The Fourth Circuit affirmed.[11] Following the Supreme Court’s decision in Talevski,[12] the Supreme Court granted certiorari, vacated, and remanded for reconsideration.[13] On remand, the Fourth Circuit reaffirmed its earlier decision.[14] The Supreme Court granted certiorari a second time.[15]
In a 6-3 decision authored by Justice Gorsuch, the Court held that § 1396a(a)(23)(A) does not clearly and unambiguously confer individual rights enforceable under § 1983.[16] Justice Thomas filed a concurring opinion calling for a “fundamental reexamination” of the Court’s § 1983 jurisprudence.[17] Justice Jackson, joined by Justices Sotomayor and Kagan, dissented, contending that § 1983’s broad language means what it says and that the free-choice-of-provider provision unambiguously confers an individually enforceable right regardless of its Spending Clause origins.[18]
III. Legal Background
A. Section 1983 and Spending Power Statutes
Section 1983 authorizes private individuals to sue state or local officials who deprive them of “any rights, privileges, or immunities secured by the Constitution and laws” of the United States.[19] In 1981, in Maine v. Thiboutot, the Supreme Court held that § 1983’s reference to “laws” means what it says—that federal statutes, not just civil rights laws enacted under the Fourteenth Amendment, can create enforceable rights.[20] Not every federal statute creates privately enforceable rights, however. The Court has emphasized that § 1983 “speaks in terms of ‘rights, privileges, or immunities,’ not violations of federal law” more generally.[21] This distinction between “rights” and mere “benefits” or “interests” has proven particularly significant for spending power statutes like Medicaid.[22]
B. The Evolving Test: From Pennhurst to Gonzaga
In Pennhurst State School and Hospital v. Halderman, the Court established that spending power legislation is much like a contract: in return for federal funds, the States agree to comply with federally imposed conditions.[23] Because states must “voluntarily and knowingly” consent to funding conditions, Congress must alert states “clear[ly]” and “unambiguously” to the consequences of accepting federal funds.[24]
Following Pennhurst, the Court adopted a relatively flexible approach to determining whether spending power statutes created enforceable rights—one that would be utilized for roughly two decades.[25] In Wright v. Roanoke Redevelopment and Housing Authority, the Court held that public-housing tenants could use § 1983 to enforce a provision of the Housing Act of 1937 that capped their rental payments at thirty percent of income.[26] The Court reasoned that tenants were the “intended beneficiaries” of the rent-ceiling provision and that the provision imposed a “binding obligation” on housing authorities.[27] Wilder v. Virginia Hospital Association similarly found enforceable rights in a Medicaid provision requiring “reasonable and adequate” reimbursement rates, reasoning that healthcare providers were “intended beneficiaries” and the mandate was “cast in mandatory rather than precatory terms.”[28] Blessing v. Freestone synthesized the Court’s precedents into a three-factor test examining: (1) congressional intent to benefit the plaintiff, (2) whether the right was too “vague and amorphous” for judicial enforcement, and (3) whether the statute “unambiguously impose[d] a binding obligation on the States.”[29]
The Court’s approach changed dramatically in 2002, with its opinion in Gonzaga University v. Doe.[30] Returning to § 1983’s text, which authorizes suits only for deprivation of “rights,” not the broader “benefits” or “interests” lower courts had been crediting, the Court concluded that Blessing’s multi-factor framework had generated unacceptable confusion, with some lower courts treating it as permitting enforcement whenever a plaintiff fell within the general zone of interest a statute was intended to protect.[31] The Gonzaga Court adopted a far more restrictive test, holding that spending power legislation cannot support § 1983 suits unless Congress “speaks with a clear voice, and manifests an unambiguous intent to confer individual rights.”[32] Gonzaga “reject[ed]” any reading of prior cases that would “permit anything short of an unambiguously conferred right to support a cause of action brought under § 1983.”[33]
C. Talevski and the Modern Framework
In 2023, the Court in Health and Hospital Corporation of Marion County v. Talevski reaffirmed Gonzaga’s demanding test while confirming that spending power statutes can create enforceable rights.[34] The Court upheld § 1983 claims based on two provisions of the Federal Nursing Home Reform Act (“FNHRA”): one protecting residents’ “right to be free from” unnecessary restraints, and another establishing “transfer and discharge rights.”[35] Talevski also rejected the argument that “§ 1983 contains an implicit carveout for laws that Congress enacts via its spending power,” affirming that “‘[l]aws’ means ‘laws,’ no less today than in the 1870s.”[36]
The Talevski Court identified the key inquiry: whether “the provision in question is ‘phrased in terms of the persons benefited’ and contains ‘rights-creating,’ individual-centric language with an ‘unmistakable focus on the benefited class.’”[37] The FNHRA provisions qualified because they “expressly” used clear “rights-creating language.”[38]
IV. Instant Decision
A. The Majority Opinion
Writing for the majority in Medina, Justice Gorsuch held that the any-qualified-provider provision “looks nothing like” the FNHRA provisions upheld in Talevski.[39] While the provision “doubtless” speaks to state duties and “seeks to benefit both providers and patients,” it lacks FNHRA’s clear “rights-creating language.”[40] The majority emphasized that Congress “knows how to” create clear rights, pointing to FNHRA’s provision giving nursing home residents “the right to choose a personal attending physician”—language conspicuously absent from the Medicaid provision.[41]
The majority found additional support in the provision’s structure and context. The provision’s exceptions allow States to exclude providers “convicted of a felony” and to “determin[e]” which convictions qualify.[42] This arrangement, the Court reasoned, “makes perfect sense if § 1396a(a)(23)(A) speaks only to a State’s duties to the federal government” but creates problems if it also confers individual rights.”[43]
The Court addressed four counterarguments raised by the plaintiffs. First, plaintiffs pointed to a similarly worded Medicare provision titled “Free choice by patient guaranteed,” but the Court observed that Congress omitted “the very language claimed to create rights” from the Medicaid provision.[44] Second, plaintiffs invoked legislative history, but the Court noted that for spending power statutes, “the key is not what a majority of the Members . . . intend but what the States are clearly told.”[45] Third, plaintiffs proposed that “individual-centric, mandatory language” should suffice, but the Court found this “obliterate[s] the distinction between mere benefits and enforceable rights.”[46] Fourth, plaintiffs argued that only § 1983 litigation can effectively enforce the provision, but the Court responded that alternative remedies exist and that “balancing enforcement costs and benefits is a policy question for Congress, not courts.”[47]
B. Justice Thomas’s Concurrence
Justice Thomas called for “a fundamental reexamination of our § 1983 jurisprudence,”[48] arguing that the statute “bears little resemblance” to its original understanding.[49] Justice Thomas questioned whether spending power statutes can ever “secure” rights as required by § 1983, arguing that conditional spending legislation “does not itself ‘secure any rights’” because its conditions “have no effect . . . unless and until they are freely accepted by the” recipient.[50]
C. Justice Jackson’s Dissent
Justice Jackson’s dissent argued that the majority “disregards the established method” from Gonzaga and Talevski and instead “looks to FNHRA itself as ‘the only reliable yardstick against which to measure whether spending power legislation confers a privately enforceable right.’”[51] In her view, the majority’s approach “warps our reasoning in Talevski” by transforming the requirement that Congress manifest “an ‘unambiguous’ intent to confer individual rights” into “a requirement that Congress manifest an unambiguous intent to imitate FNHRA.”[52]
The dissent argued that the any-qualified-provider provision satisfies the Gonzaga test. The provision is “plainly ‘phrased in terms of the persons benefited’”—namely, Medicaid recipients—and Congress used “rights-creating language” in the original session law’s heading: “Free choice by individuals eligible for medical assistance.”[53] The dissent also invoked the Court’s prior characterization of the provision in O’Bannon v. Town Court Nursing Center, which repeatedly used the word “right,” observing that § 1396a(a)(23) “gives recipients the right to choose among a range of qualified providers, without government interference.”[54]
V. In Defense of Medina
Beyond rebutting the specific criticisms of the Court’s decision, there is an affirmative case for Medina’s approach that is underappreciated. The Gonzaga/Talevski/Medina line of cases reflects a coherent structural principle: in a federal system where Congress uses its spending power to enlist states as partners in administering massive social programs, the terms of that partnership must be legible to all parties. Courts are not well positioned to determine, after the fact, whether Congress “really” intended to expose states to individual § 1983 liability when it used language that could as easily be read as directing program administration toward the federal government. That kind of retrospective intent-divination is precisely what Pennhurst warned against.[55] The clarity requirement is not a technicality that thwarts congressional purpose; it is the mechanism by which congressional purpose is made knowable.
Medina also provides an important practical benefit that critics have not fully credited: it is navigable. As the lower-court decisions surveyed in Part VI demonstrate, courts applying Medina can distinguish between provisions that do and do not create enforceable rights with relative predictability. The McKinney-Vento Homeless Assistance Act (“McKinney-Vento) survives; § 3027 of the Older Americans Act (“OAA”) does not. FNHRA’s § 1396r(c) survives; §§ 1396r(b), (d), and (f) do not. These distinctions track actual differences in statutory language rather than judges’ intuitions about congressional purpose, which is exactly what a workable legal standard should do.
VI. Medina in the Lower Courts
In the months following Medina, lower courts have begun applying its framework across a wide range of federal spending power statutes. These early decisions confirm both the coherence and workability of Medina’s analytical framework, with courts rejecting claims based on provisions lacking explicit rights-creating language while preserving enforcement where statutes contain Talevski-style rights language.[56]
A. Expansion to Other Medicaid Provisions
Lower courts have applied Medina’s reasoning to reject § 1983 claims based on other provisions of 42 U.S.C. § 1396a(a) that lack explicit rights-creating language. In Lancaster v. Cartmell, the Tenth Circuit held that § 1396a(a)(8), the “reasonable promptness” provision requiring states to furnish medical assistance “with reasonable promptness to all eligible individuals,” does not confer privately enforceable rights under § 1983.[57] The court emphasized that the provision, like § 1396a(a)(23)(A), is nested within a subsection listing “requirements States must substantially comply with to receive Medicaid funding” and is “directed to the Secretary of Health and Human Services for plan approvals.”[58] As the court explained, “Medina teaches that mandatory language alone does not create individually enforceable rights.”[59]
The Lancaster court expressly declined to follow Third Circuit precedent that had previously found § 1396a(a)(8) enforceable,[60] demonstrating how Medina operates not merely as a rule of decision for the any-qualified-provider provision, but as a clarification of the analytical framework applicable to all Medicaid plan requirements.[61] Along the same vein, the Seventh Circuit in Indiana Protection and Advocacy Services Commission v. Indiana Family and Social Services Administration acknowledged that Medina “may well have undermined the availability of [§ 1983] to enforce” Medicaid provisions that the circuit had previously assumed were privately enforceable, including §§ 1396a(a)(8), (a)(10)(A), and (a)(43)(C).[62]
In Washington v. Daviess County Hospital, a district court applied Medina to distinguish among FNHRA subsections, holding that claims under §§ 1396r(b), (d), and (f) fail because those provisions lack “the same sort of rights-creating, individual-centric language necessary to confer an enforceable right.”[63] Claims under § 1396r(c)—the provision titled “Requirements relating to residents’ rights” that was at issue in Talevski—remain viable.[64] This nuanced application demonstrates that Medina does not categorically foreclose FNHRA claims but rather requires courts to assess each provision individually against the Talevski benchmark. [65]
B. Extension to Non-Medicaid Spending Power Legislation
Courts have extended Medina’s framework beyond the Medicaid context, bringing needed consistency to the analysis of § 1983 claims across federal spending power legislation. In Emrich Aerial Spraying LLC v. City of Pawhuska, a district court held that Federal Aviation Administration grant assurances under 49 U.S.C. § 47107 do not create § 1983-enforceable rights.[66] The court reasoned that “consent cannot be fairly inferred if the federal spending-power statute fails to provide ‘clear and unambiguous’ notice that it creates a personally enforceable right.”[67]
The Seventh Circuit reached a similar conclusion regarding the Older Americans Act in Northwestern Illinois Area Agency on Aging v. Basta.[68] The court held that § 3027 of the OAA does not create individually enforceable rights, identifying three textual deficiencies under the Talevski/Medina framework.[69] First, the provision “speaks only in terms of the states”—dealing with “giving funds to states, withholding those funds from states, [and] allowing states to appeal findings made by the federal government . . . .”[70] Second, the remedy for noncompliance is termination of federal funding, which Pennhurst recognized as “the typical remedy for state noncompliance” rather than an indicator of private enforcement rights.[71] Third, the provision contains “no mention of individual ‘rights,’ ‘privileges,’ ‘immunities,’ or any similar language.”[72]
Similarly, in Timken v. South Denver Cardiology Associates, the Tenth Circuit rejected § 1983 claims based on the Emergency Use Authorization statute, the PREP Act, and Department of Defense spending provisions, observing that Medina “repeatedly cautioned that legislation passed through the spending power is more unlikely to create § 1983-enforceable rights than laws passed under other enumerated powers.”[73]
C. Statutes Distinguished from Medina
Importantly, Medina has not categorically foreclosed § 1983 enforcement of spending power statutes. Courts have preserved enforcement where statutes contain explicit rights-creating language resembling the FNHRA provisions upheld in Talevski. In Williams v. Cheltenham School District, a district court held that the McKinney-Vento Homeless Assistance Act survives Medina’s framework.[74] The court emphasized that while Medina “clarified the applicable standard,” it “did not change” the fundamental inquiry: whether Congress used explicit rights-creating language with an unmistakable focus on individual beneficiaries.[75]
Unlike the Medicaid provision in Medina, which merely directed states to allow beneficiaries to “obtain” assistance from qualified providers, McKinney-Vento is “replete with statutory language specifically conferring rights on the parents of homeless children,” expressly gives parents “the right to appeal” school placement decisions and requires that parents “shall be provided with a written explanation of any decisions.”[76] The court found these provisions “far more analogous to the enforceable rights provisions in Talevski than to the Medicaid provision the Court found insufficient in Medina.”[77]
Congress’s language in McKinney-Vento—with its explicit references to “rights,” its mandatory notice requirements “phrased in terms of the persons benefited,” and its “binding obligations on local educational agencies through clear ‘rights-creating language’”—gave states “clear and unambiguous notice that, if it accepts federal funds, it may face private suits asserting an individual right.”[78] This is precisely how Medina should operate: filtering out the “almost right” words while preserving enforcement for provisions using the “right” words. The contrast between McKinney-Vento and the any-qualified-provider provision is not a product of judicial wordsmithing or arbitrary formalism; it reflects a real difference in how Congress chose to speak.
VII. Conclusion
Medina was decided against a backdrop of genuine human stakes: a Medicaid beneficiary losing access to a trusted provider, a state asserting policy prerogatives over federally funded programs, and a Court trying to hold a doctrinal line that prior opinions had blurred. The critics who say the majority got it wrong are not arguing in bad faith. The any-qualified-provider provision does use mandatory language, does focus on individual beneficiaries, and was plainly designed to give them something.[79] The question Medina answers is whether that something rises to the level of a judicially enforceable right—and the answer, correctly reached, is no.
That answer is correct because Pennhurst’s contract logic is sound: states that accept federal funds are entitled to know, from the statutory text, which conditions will expose them to private litigation.[80] It is correct because Gonzaga’s textual anchor is sound: § 1983 says “rights,” not “benefits,” and that word must mean something.[81] And it is correct because the alternative—inferring rights from individual focus and mandatory language alone—would swallow the Gonzaga rule entirely, restoring the confusion it was meant to end.[82] The remedy for inadequate enforcement is legislation, not judicial gap-filling.[83]
As early post-Medina decisions confirm, the framework works. Where Congress uses the “right” words, courts enforce them. Where it uses the “almost right” words, courts cannot fill the gap. That discipline, however uncomfortable in individual cases, keeps courts in their proper constitutional role. The difference, as Twain recognized, is “really a large matter.”[84]
* B.S., Murray State University, 2018; M.B.A., Murray State University, 2023; J.D. Candidate, University of Missouri School of Law, 2026; Associate Editor, Missouri Law Review, 2025–2026. I am grateful to Christy Hoffmann, William Perryman, and Rachel Carlson for their help in the editing process.
[1] Mark Twain, The Art of Authorship 87–88 (George Bainton ed., 1890).
[2] Medina v. Planned Parenthood S. Atl., 606 U.S. 357, 385 (2025) (“Section 1983 permits private plaintiffs to sue for violations of federal spending-power statutes only in ‘atypical’ situations . . . where the provision in question ‘clear[ly]’ and ‘unambiguous[ly]’ confers an individual ‘right.’ Section 1396a(a)(23)(A) is not such a statute.”).
[3] Id. at 377–78.
[4] Laura S. Richman, Medina v. Planned Parenthood South Atlantic: Another Setback to Patients’ Rights and Healthcare Access for Vulnerable Populations, Geo. Wash. L. Rev. On the Docket (July 22, 2025), https://www.gwlr.org/medina-another-setback-to-patients-rights-and-healthcare-access.
[5] Medina, 606 U.S. at 364.
[6] Id. at 364.
[7] Id. at 365.
[8] 42 U.S.C. § 1396a(a)(23)(A).
[9] H.R. Rep. No. 90-544, at 122 (1967).
[10] Planned Parenthood S. Atl. v. Baker, 487 F. Supp. 3d 443, 448 (D.S.C. 2020).
[11] Planned Parenthood S. Atl. v. Kerr, 27 F.4th 945, 959 (4th Cir. 2022).
[12] Health & Hosp. Corp. of Marion Cnty. v. Talevski, 599 U.S. 166 (2023).
[13] Kerr v. Planned Parenthood S. Atl., 143 S. Ct. 2633 (2023).
[14] Planned Parenthood S. Atl. v. Kerr, 95 F.4th 152, 169 (4th Cir. 2024).
[15] Medina v. Planned Parenthood S. Atl., 606 U.S. 357, 364 (2025)
[16] Id. at 385–86.
[17] Id. at 397 (Thomas, J., concurring).
[18] Id. at 402, 407–10, 417 (Jackson, J., dissenting).
[19] 42 U.S.C. § 1983. Originally enacted as part of the Civil Rights Act of 1871, the statute was designed to combat widespread violence and intimidation against newly freed citizens in the post-Civil War South. See Mitchum v. Foster, 407 U.S. 225, 239 (1972).
[20] Maine v. Thiboutot, 448 U.S. 1, 4 (1980).
[21] Golden State Transit Corp. v. Los Angeles, 493 U.S. 103, 106 (1989) (quoting Pennhurst State Sch. and Hosp. v. Halderman, 451 U.S. 1, 19 (1981)).
[22] Gonzaga Univ. v. Doe, 536 U.S. 273, 283 (2002).
[23] Pennhurst State Sch. & Hosp. v. Halderman, 451 U.S. 1, 17 (1981).
[24] Id.
[25] See Wright v. City of Roanoke Redevelopment & Hous. Auth., 479 U.S. 418 (1987); Wilder v. Va. Hospital Ass’n., 496 U.S. 498 (1990); Blessing v. Freestone, 520 U.S. 329 (1997).
[26] Wright, 479 U.S. at 430–32.
[27] Id. at 430.
[28] Wilder, 496 U.S. at 510, 512.
[29] Blessing, 520 U.S. at 340–41.
[30] Gonzaga Univ. v. Doe, 536 U.S. 273 (2002).
[31] Id. at 282–83. The Court acknowledged candidly that its prior opinions “may not be models of clarity” and that “[s]ome language” in them “might be read to suggest that something less than an unambiguously conferred right is enforceable by § 1983.” Id. at 282.
[32] Id. at 280. The Court aligned this standard with the implied-right-of-action inquiry, requiring that statutory text be “phrased in terms of the persons benefitted” with “an unmistakable focus on the benefitted class.” Id. at 283–85 (quoting Cannon v. Univ. of Chicago, 441 U.S. 677, 692 n.13 (1979)). While it aligned the threshold with this standard, it clarified that § 1983 plaintiffs still need not separately demonstrate congressional intent to create a private remedy, since § 1983 supplies that remedy once a right is established. Id. at 285–86.
[33] Id. at 283.
[34] Health & Hosp. Corp. of Marion Cnty. v. Talevski, 599 U.S. 166, 183 (2023).
[35] Id. at 184–85.
[36] Id. at 171–72.
[37] Id. at 183 (quoting Gonzaga, 536 U.S. at 284, 287).
[38] Id. at 184, 186.
[39] Medina v. Planned Parenthood S. Atl., 606 U.S. 357, 377 (2025).
[40] Id. at 377–78.
[41] Id. at 378 (quoting 42 U.S.C. § 1396r(c)(1)(A)(i)).
[42] Id. at 378–79.
[43] Id. at 379. The Court also noted that the provision appears as “paragraph 23 of 87 plan requirements directed to the Secretary, without discernible organizational principle,” further suggesting that it addresses state duties rather than individual rights. Id.
[44] Id. at 381–82. Both programs were established when President Lyndon B. Johnson signed the Medicare and Medicaid act into law on July 30, 1965. Medicare and Medicaid Act (1965), Nat’l Archives, https://www.archives.gov/milestone-documents/medicare-and-medicaid-act (last visited Mar. 12, 2026).
[45] Medina, 606 U.S.at 381 (quoting Arlington Cent. Sch. Dist. Bd. of Educ. v. Murphy, 548 U.S. 291, 304 (2006)).
[46] Id. at 382.
[47] Id. at 384–85.
[48] Id. at 386 (Thomas, J., concurring).
[49] Id. at 387–89.
[50] Id. at 392–93.
[51] Id. at 411 (Jackson, J., dissenting).
[52] Id.
[53] Id. at 407–08.
[54] O’Bannon v. Town Court Nursing Ctr., 447 U.S. 773, 785 (1980).
[55] Pennhurst State Sch. & Hosp. v. Halderman, 451 U.S. 1 (1981).
[56] United States v. Oropesa, 159 F.4th 912, 917 (11th Cir. 2025) (stating that Medina’s framework applies to civil enforcement under § 1983, not criminal prosecutions). This is because § 241’s text “is plain and unlimited” and the “presumption against implied private causes of action” animating Medina has “little bearing in the criminal context.” Id. at 917–918.
[57] Lancaster v. Cartmell, 162 F.4th 1063, 1064 (10th Cir. 2025). The Lancasters had transferred approximately $3.8 million in property to a family LLC and then applied for Medicaid benefits; when their applications were denied based on an asset determination, they sued under § 1983, claiming the agencies violated § 1396a(a)(8)’s requirement to “promptly provide Medicaid benefits to eligible individuals.” Id. at 1064–65.
[58] Id. at 1068.
[59] Id. at 1069.
[60] Id. at 1069 (discussing Sabree v. Richman, 367 F.3d 180 (3d Cir. 2004)). The court reasoned that this earlier decision had “heavily lean[ed] on the three Supreme Court cases disclaimed in Medina: Wright, Wilder, and Blessing.” Id. at 1069–70.
[61] See id. at 1069–70; see also Nansemond Indian Nation v. Virginia, 795 F.Supp.3d 733 (E.D. Va. 2025) (rejecting tribal healthcare providers’ claims that §§ 1396a(a)(8) and (a)(13)(A) created enforceable rights, reasoning that “[w]hile ‘shall’ expresses a mandate, it does not create a right” under Medina’s framework).
[62] Ind. Prot. & Advocacy Servs. Comm’n v. Ind. Family & Soc. Servs. Admin., 149 F.4th 917, 926 (7th Cir. 2025). Though the court ultimately resolved the case on ADA grounds, it signaled that circuit precedent recognizing enforceable rights in these provisions may require reconsideration under Medina’s “demanding bar.” Id.
[63] Washington v. Daviess Cnty. Hosp., No. 3:23-cv-155, 2025 WL 2944258, at *3 (S.D. Ind. 2025).
[64] Id. The plaintiff, a nursing home resident, alleged violations of multiple FNHRA provisions. The court permitted claims under the provisions upheld in Talevski—those appearing under the heading “Requirements relating to residents’ rights”—while dismissing claims under provisions governing facility administration that lacked comparable rights-creating language. Id.
[65] See id.
[66] Emrich Aerial Spraying LLC v. City of Pawhuska, No. 24-cv-324, 2025 WL 2987889, at *11 (N.D. Okla. 2025). The plaintiff, an aerial spraying company, alleged the city violated FAA grant assurances by interfering with its access to a municipal airport. Id. at *3, *11.
[67] Id. at *10 (quoting Medina v. Planned Parenthood S. Atl., 606 U.S. 357, 370, 377 (2025)).
[68] Nw. Ill. Area Agency on Aging v. Basta, 145 F.4th 695 (7th Cir. 2025). The plaintiff, an area agency designated under the OAA to provide services to senior citizens in northwestern Illinois, alleged that the former director of the Illinois Department on Aging unlawfully refused to hold hearings on administrative petitions. Id. at 697.
[69] Id. at 703–04.
[70] Id. at 704 (emphasis in original).
[71] Id. at 703 (quoting Pennhurst State Sch. & Hosp. v. Halderman, 451 U.S. 1, 28 (1981)).
[72] Id. at 704. The court contrasted § 3027 with the FNHRA provisions upheld in Talevski, which “required nursing homes to protect ‘transfer and discharge rights’ and ‘protect and promote the right to be free from any physical or chemical restraints.’” Id. at 703–04 (quoting Health & Hosp. Corp. of Marion Cnty. v. Talevski, 599 U.S. 166, 184–85 (2023)). The court emphasized that Medina permits § 1983 suits “only in ‘atypical’ situations,” and the OAA is not such a statute. Id. at 704 (quoting Medina v. Planned Parenthood S. Atl., 606 U.S. 357, 380 (2025)).
[73] Timken v. S. Denver Cardiology Assocs., PC, 155 F.4th 1227, 1240 (10th Cir. 2025). The plaintiffs alleged that healthcare providers violated their rights under various federal statutes by administering COVID-19 vaccines without proper informed consent. The court rejected all claims, finding that none of the cited provisions contained the explicit rights-creating language required by Medina. Id. at 1234–36, 1240.
[74] Williams v. Cheltenham Sch. Dist., No. 25-3395, 2025 WL 2712217 (E.D. Pa. Sept. 23, 2025). The plaintiff, a mother whose children were removed from school enrollment without the required notice and appeal process, alleged the district violated her rights under both FERPA and McKinney-Vento. The court dismissed the FERPA claim under Gonzaga but permitted the McKinney-Vento claim to proceed. Id. at *2–*5.
[75] Id. at *3.
[76] Id. at *4 (quoting 42 U.S.C. §§ 11432(g)(3)(E), (g)(6)(A)(iv), (vi)). The Act also mandates that school liaisons ensure parents are “informed of the educational and related opportunities available to their children” and that “public notice of the educational rights of homeless children” is disseminated in a manner “understandable to the parents.” Id.
[77] Id. at *5.
[78] Id. at *4–*5. The court relied on Martin v. Piserchia, an earlier district court decision holding that McKinney-Vento creates enforceable rights, and noted that the Court of Appeals had “assumed without deciding” that parents may sue to enforce the Act. Id. at *3.
[79] Medina v. Planned Parenthood S. Atl., 606 U.S. 357, 397–418 (2025) (J., Jackson, dissenting).
[80] Pennhurst State Sch. & Hosp. v. Halderman, 451 U.S. 1, 17 (1981).
[81] Gonzaga Univ., 536 U.S. 273, 283 (2002).
[82] Id. at 282–83 (criticizing the pre-Gonzaga framework for generating “unacceptable confusion” by permitting enforcement whenever a plaintiff fell within a statute’s general zone of interest).
[83] Medina, 606 U.S. at 384–85.
[84] Twain, supra note 1, at 87–88.