A U.S. district court holds that requiring a Medicaid applicant to
reside in-state for a period of time before her benefits are determined
is a violation of her fundamental right to interstate travel as
guaranteed under the U.S. Constitution. Duffy, et al., v. Meconi, et al. (Del., C.A., No. 05-127, Sept. 11, 2007).

Marianne Duffy, a 33-year-old Medicaid beneficiary, had resided
in North Carolina since 1994. Ms. Duffy suffers from "developmental
disabilities including blindness, seizures, autism, and mental
retardation," which require her to live in an intermediate care
facility for mental retardation (ICF/MR). In 2001, Ms. Duffy’s parents
moved from North Carolina to Delaware. After their move, the Duffys
decided to relocate their daughter to Delaware and attempted to obtain
Medicaid benefits through Delaware’s program.

Delaware’s Division of Developmental Disabilities Services
determined that Ms. Duffy was not a resident of Delaware, and therefore
not entitled to Delaware’s Medicaid benefits. That finding, in
combination with Ms. Duffy’s inability to privately guarantee payment
for a facility, had effectively prevented Ms. Duffy’s enrollment in an
ICF/MR facility in Delaware.

Ms. Duffy sued, alleging that Delaware’s refusal to award her
residential placement and services restrained her fundamental right to
interstate travel and thus violated the Constitution’s Privileges and
Immunities Clause of Article IV, the Privileges and Immunities Clause
of the Fourteenth Amendment and, the Equal Protection Clause of the
Fourteenth Amendment.

The District Court of Delaware grants Ms. Duffy’s motion for
summary judgment, holding that the state’s requirement of Ms. Duffy to
first move to Delaware, at her own expense, before they will determine
her Medicaid eligibility is effectively a veiled durational residency
requirement, which is unconstitutional. Delaware must process Ms.
Duffy’s application for Medicaid benefits before she is physically present in the state.