United States Court of Appeals, District of Columbia Circuit
Oscar Salazar, by his parents and next friends, Adela and Oscar Salazar, et al., Appellees
District of Columbia, et al., Appellants Chartered Health Plan, Appellee
September 25, 2017
Appeals from the United States District Court for the
District of Columbia (No. 1:93-cv-00452)
Richard S. Love, Senior Assistant Attorney General, Office of
the Attorney General for the District of Columbia, argued the
cause for appellants. With him on the briefs were Karl A.
Racine, Attorney General, Todd S. Kim, Solicitor General at
the time the briefs were filed, and Loren L. AliKhan, Deputy
Solicitor General at the time the briefs were filed.
Kathleen L. Millian argued the cause for
plaintiffs-appellees. With her on the briefs were Martha Jane
Perkins, Zenia Sanchez Fuentes, and Lynn E. Cunningham.
Jonathan H. Levy, Allen Snyder, and Daniel Bruner were on the
brief for amici curiae Legal Aid Society of the District of
Columbia, et al. in support of appellees.
Before: Henderson and Millett, Circuit Judges, and Ginsburg,
Senior Circuit Judge.
MILLETT, CIRCUIT JUDGE
case involves an injunction garbed in the clothing of a
consent decree modification. While district courts generally
have discretion under Federal Rule of Civil Procedure
60(b)(5) to adjust the terms of an existing consent decree in
light of changed circumstances, the issuance of a new
injunction must meet the strict preconditions for such
exceptional relief set out in Federal Rule of Civil Procedure
65. Because the district court's order in this case
provided brand new relief based on brand new facts alleging
violations of a new law without the requisite findings for an
injunction, it crossed the line from permissibly modifying
into impermissibly enjoining. For that reason, we reverse the
district court's order, vacate the new injunctive relief,
and remand for proceedings consistent with this opinion.
of background, under long-established practice, federal
courts may enter, as final judicial orders, consent decrees
that reflect the agreement of the parties to forward- going
injunctive relief, as long as the consent decree arises from
and resolves a dispute "within the court's
subject-matter jurisdiction[.]" Frew v.
Hawkins, 540 U.S. 431, 437 (2004). Once a consent decree
has been entered, Federal Rule of Civil Procedure 60(b)
empowers the court to modify its terms to the same extent as
any other final judgment. See United States v. Western
Elec. Co., 46 F.3d 1198, 1205 (D.C. Cir. 1995) (citing
System Fed'n No. 91 v. Wright, 364 U.S. 642, 651
(1961)); see also Plaut v. Spendthrift Farm, Inc.,
514 U.S. 211, 233-234 (1995) ("Rule 60(b) * * * merely
reflects and confirms the courts' own inherent and
discretionary power, firmly established in English practice
long before the foundation of our Republic, to set aside a
judgment whose enforcement would work inequity.")
(internal quotations and citations omitted).
relevant here, Rule 60(b) permits modification or relief from
a judgment when: (i) it "has been satisfied, released or
discharged;" (ii) "it is based on an earlier
judgment that has been reversed or vacated;" (iii)
"applying it prospectively is no longer equitable,"
Fed.R.Civ.P. 60(b)(5); or (iv) there is "any other
reason that justifies relief," Fed.R.Civ.P. 60(b)(6).
party seeks relief under Rule 60(b), that party bears the
threshold burden of proving that a "significant
change" in legal or factual circumstances "warrants
revision of the decree." Rufo v. Inmates of Suffolk
Cty. Jail, 502 U.S. 367, 383 (1992). For a change in the
law to be significant, it must "make legal what the
decree was designed to prevent," or otherwise effect a
material change in the governing legal regime. Id.
at 388. A change in the facts qualifies as significant if it
makes compliance with the decree "substantially more
onerous," "unworkable because of unforeseen
obstacles," or "detrimental to the public
interest." Id. at 384.
XIX of the Social Security Act, 42 U.S.C. § 1396, et
seq.-commonly known as Medicaid-is a federal subsidy
program that underwrites participating States' provision
of medical services to "families with dependent children
and [to] aged, blind, or disabled individuals, whose income
and resources are insufficient to meet the costs of necessary
medical services." Armstrong v. Exceptional Child
Ctr., Inc., 135 S.Ct. 1378, 1382 (2015) (quoting 42
U.S.C. § 1396-1). Participating States receive federal
funds that are subject to congressionally mandated controls
and directives. See id.
exceptions not relevant here, both federal and local law have
long required the District of Columbia to make Medicaid
eligibility determinations within 45 days of an application
for benefits, 42 C.F.R. § 435.912(c)(3); D.C. Code
§ 4-205.26, and to provide Medicaid recipients timely
notice of any proposed termination, discontinuation, or
suspension of eligibility, see, e.g., 42 C.F.R.
§§ 435.919(a), 431.200 (1993). As a general rule,
the District must annually "recertify"-that is,
renew-the eligibility of its Medicaid recipients to maintain
their benefits. Compare 42 C.F.R. § 435.916
(2016) (prescribing "renewal" of Medicaid
eligibility), with Salazar v. District of Columbia,
954 F.Supp. 278, 292-294 (D.D.C. 1996) ("Liability
Order") (referring to the legacy eligibility
redetermination process as "recertification").
the District conducted the application and recertification
processes by paper and mail. That system required
beneficiaries to take the affirmative step of mailing in the
required paperwork to continue their benefit eligibility.
See Liability Order, 954 F.Supp. at 282-283, 292.
2010, the Patient Protection and Affordable Care Act, Pub. L.
111-148, 124 Stat. 119 et seq. ("Affordable
Care Act"), wrought several changes in the
District's eligibility and recertification processes.
Under the Affordable Care Act, the majority of Medicaid
applicants and recipients have their eligibility determined
by the amount of modified adjusted gross income that they
report on their federal income taxes. The Act thus uses
household tax information to assess income, household
composition, and family size. See 42 C.F.R.
§§ 435.901-435.911, 435.916.
such tax-based eligibility determinations, the District had
to replace its old paper recertification system with a new
passive renewal model. The passive renewal program first
attempts to automatically renew eligibility based on
available electronic federal and local tax records.
See 42 C.F.R. § 435.916(a). If the data
necessary for passive renewal are unavailable, then the
District must ask the Medicaid recipient to provide the
missing information before renewing Medicaid eligibility.
Id. § 435.916(a)(3).
District began to implement its passive renewal system in
late 2012 by building a new, automated eligibility system
called the DC Access System. When the DC Access System is
fully realized, the District plans to retire its legacy
application and recertification system. However, the
transition from the old system to the new DC Access System
has been halting, due to "technology challenges,
contracting issues, and funding." J.A. 827. The plodding
transition between systems proved problematic for many
individuals' Medicaid application and renewal process.