Delores Polk v. Betty Yee, 36 F.4th 939

Appellants are California IHSS Medicaid providers who joined public‑sector unions (SEIU or UDW) and authorized the State Controller to deduct union dues from their payroll; they later resigned outside revocation windows but deductions continued.
Appellants filed putative class actions under 42 U.S.C. § 1983 against the unions and State Controller Betty Yee alleging First Amendment and Medicaid Act (anti‑reassignment) violations.
The anti‑reassignment provision, 42 U.S.C. § 1396a(a)(32), bars Medicaid plan payments to anyone other than the provider or recipient; it was enacted to prevent "factoring" and related fraud/administrative abuses.
District courts dismissed: First Amendment claims were foreclosed (and later conceded in light of Belgau), and the courts held the anti‑reassignment provision does not create a private right enforceable under § 1983.
Ninth Circuit consolidated the appeals and reviewed de novo whether § 1396a(a)(32) confers an individual right under the Blessing/Gonzaga framework.
The court held § 1396a(a)(32) does not confer a § 1983‑enforceable right on Medicaid providers because its text and legislative history show an administrative, fraud‑prevention focus—not an intent to benefit providers—and affirmed.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether 42 U.S.C. § 1396a(a)(32) confers a private right enforceable under § 1983	The anti‑reassignment rule prohibits payments to third parties (including dues deductions) and thus protects providers, creating an individually enforceable right	The provision regulates state payment practices to prevent factoring/fraud and was not intended to create individual rights for providers	No. The statute's language and legislative history show an administrative/fraud‑prevention focus; no § 1983 right for providers; dismissal affirmed
Whether appellants’ First Amendment claim survives	Continued deductions compelled association/speech	Unions are not state actors and consent/precedent bar the claim	Foreclosed by Belgau; appellants conceded that precedent controls

Blessing v. Freestone, 520 U.S. 329 (1997) (establishes three‑part test for when federal spending statutes create § 1983 rights)
Gonzaga Univ. v. Doe, 536 U.S. 273 (2002) (requires rights‑creating language for an enforceable private right)
Sanchez v. Johnson, 416 F.3d 1051 (9th Cir. 2005) (refused to find § 1983 right where Medicaid text/structure did not show intent to benefit providers)
Ball v. Rodgers, 492 F.3d 1094 (9th Cir. 2007) (distinguishes statutes focused on individual beneficiaries from those addressing aggregate administrative policy)
All. of Nonprofits for Ins., Risk Retention Grp. v. Kipper, 712 F.3d 1316 (9th Cir. 2013) (legislative history can show Congress intended only incidental benefits, not enforceable private rights)
Planned Parenthood Ariz. Inc. v. Betlach, 727 F.3d 960 (9th Cir. 2013) (example of Medicaid language that does create an enforceable right)
Belgau v. Inslee, 975 F.3d 940 (9th Cir. 2020) (rejects a similar First Amendment challenge to payroll deductions)