6th Circuit Says Spouse as Family Is No-Brainer

     (CN) – Ohio cannot deny seniors Medicaid benefits by defining “family” to exclude their spouse, the Sixth Circuit ruled.
     “Ask 100 Americans whether a 74 year-old man’s ‘family’ includes his wife who lives with him, and every one of those Americans will likely answer yes,” Judge Raymond Kethledge wrote for a three-member panel. “But here the Ohio Department of Medicaid answered no.”
     Leslie Wheaton, George Hart and Joe Turner are Medicare beneficiaries, each of whom are married and live with their spouse, according to court records. Each man has a monthly income of about $1,300, which would qualify them for Medicaid assistance payments if their wives were included as part of their “family” for eligibility purposes.
     But Ohio does not count a Medicare beneficiary’s spouse as a member of his or her “family,” the ruling states. The Cincinnati-based appeals court held Tuesday that the state’s exclusion of a beneficiary’s spouse from the definition of family was impermissible, reversing the decision of a Southern Ohio district court.
     “Reasonable people might disagree, as a matter of ordinary usage, as to whether the term ‘family’ should include adult children who live with their parents, or a 17 year-old child who does not, or nieces and nephews who live with their aunts and uncles,” Kethledge said. But there is no ambiguity as to whether a person’s husband or wife is a member of their family, the Sixth Circuit ruled.
     “The term ‘planet’ might be ambiguous as applied to Pluto, but is clear as applied to Jupiter. And though there might be some ambiguity in 2015 as to whether Ukraine’s borders encompass the Crimean Peninsula, there is no doubt that Kiev lies within them,” the judge wrote. “So too here: whatever ambiguity the ‘persons living under one roof’ or ‘basic unit of society’ definitions might have at the margins, there is no doubt that, under either definition, a person’s family includes her resident spouse.”
     Ohio made a number of technical arguments to defend its interpretation of the law, but the appeals court dismissed them all.
     “That a statute is complicated does not mean an agency can interpret it any way the agency wants. And the operative term as applied here – ‘family’ – is simple,” Kethledge said.

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