The U.S. Supreme Court last week re-fused to reinstate a policy of Arizona's healthcare program for the poor that denied liver transplants to people older than 18.
The justices, without comment, let stand a ruling that found federal law was violated by the policy of the Arizona Health Care Cost Containment System, Arizona's version of Medicaid.
The policy was struck down by the Arizona state Supreme Court last July after lower courts rejected a challenge by AHCCCS recipient Elizabeth Salgado and Pima County.
Salgado, a Pima County resident, was 44 when she applied for Medicaid coverage of a liver transplant physicians said she needed to save her life. Under Arizona Medicaid, however, a liver transplant is not covered for anyone over 18.
Pima County officials agreed to pay for Salgado's transplant and then joined her in suing the state over its refusal to finance the operation.
The lawsuit contended that the federal Medicaid law requires that all "similarly situated" people, no matter their age, be treated alike.
Arizona officials responded that children and adults with liver diseases are not "similarly situated" for purposes of receiving federal and state funding.
A state trial judge and appeals court upheld the state policy, but the ArizonaTransplants
Supreme Court ruled that the policy violated federal law and unreasonably denied services.
"The selection of age as the sole criterion, without regard to other medical factors, is wholly unrelated to the medical decision at hand," the state Supreme Court ruling said.
In their appeal, state officials said the state court ruling "eliminates the choice Arizona made of not covering transplants generally but covering them for children.... Should budget constraints lead Arizona to eliminate coverage even for children... no one will benefit."
Lawyers for Salgado and Pima County noted that the overwhelming majority of states provide Medicaid funding for adult liver transplants.