On Tuesday, April 29, 2025, the Supreme Court announced its 7-2 decision in Advocate Christ Medical Center v. Kennedy, which Justice Amy Coney Barrett, writing for the majority, described as “highly technical”.
At issue was whether hospitals would receive disproportionate share payments regardless of whether SSI program participants actually received benefits during any given month when such participants were entitled to receive benefits. The U.S. Court of Appeals for the D.C. Circuit held that the government offered the correct interpretation: there are key distinctions between the programs, so the meaning of the term “entitled to benefits” was different when applied to the two different programs.
In her opinion, Justice Barrett indicated that because SSI benefits are “cash benefits”, and eligibility for those benefits is determined on a monthly basis, therefore “an individual is considered ‘entitled to [SSI] benefits’ . . . only if she is eligible for such benefits during the month of her hospitalization.”
In her dissent, joined by Justice Sonia Sotomayor, Justice Ketanji Brown Jackson argued that the majority fundamentally misunderstood how SSI cash-benefit payments worked, and that the goal of Congress was not to tie the disproportionate share payments only to those who met a second event that triggered the SSI cash payment. Instead, Congress meant to tie those payments to those eligible to be in the programs that might entitle the individual to a payment in a time of need, which has the effect of decreasing payments to those hospitals serving patients who might be most in need of the benefits of the disproportionate share payments.