In a 5-4 ruling today, the Supreme Court held that parties cannot challenge directly in federal court a state’s compliance with Section 30(a) of the Medicaid Act, which requires states to reimburse providers at rates sufficient to ensure beneficiaries enjoy the same access to health care as the general population. The dissenting opinion written by Justice Sonia Sotomayor argued that federal courts had authority to enjoin violations of federal law under their inherent equitable authority. The AHA and Federation of American Hospitals had urged the court to uphold the right of health care providers to take states to court when they fail to live up to their payment obligations under the Medicaid Act. “[S]uch suits are crucial to preserving access to the level of care Congress intended Medicaid to provide,” the organizations said in a friend-of-the-court brief. “…In 2012, the cost of providing care to Medicaid beneficiaries exceeded reimbursements by $13.7 billion, up from $11.3 billion in 2009. This persistent gap threatens the availability of quality medical care for tens of millions of people.”