The district court
1
dismissed Greta Arlene Hudson’s § 1983 claim against the Directors of the Missouri Family Support Division and Department of Social Services (the Division) based on the abstention doctrine set forth in
Younger v. Harris,
I.
The Division denied Hudson’s application for Medicaid benefits on the grounds that she had transferred property in 2005-2006 valued at $340,000. Hudson requested and was granted a hearing to contest the denial of both her application for Medicaid health insurance and her application for Medical Assistance vendor benefits. The hearing initially was scheduled for November 4, 2009, but was continued to December 23, 2009, to allow the Division’s eligibility specialist to obtain counsel. During the continuance, Hudson received a notice of case action indicating that the Division was relying upon a different reason for denying Hudson’s application for Medicaid benefits. Because the hearing officer believed that he lacked subject matter jurisdiction to hear an appeal from the withdrawn reason for denial, Hudson was informed that she needed to file a second hearing request. Her original request for hearing was withdrawn at the Division’s request. 3 Hudson did not file a second hearing request but instead filed this § 1983 action in the Western District of Missouri seeking declaratory and injunctive relief. It is from the district court’s dismissal of this action that Hudson now appeals.
II.
We review a district court’s decision to abstain for abuse of discretion, with underlying legal determinations receiving plenary review.
Aaron v. Target Corp.,
*987
The
Younger
abstention doctrine derives from notions of federalism and comity.
Younger
itself held that, absent extraordinary circumstances, federal courts should not enjoin pending state criminal prosecutions.
See Younger,
Putting aside for the moment the question whether Hudson’s underlying state proceeding is ongoing, we turn to Hudson’s contention that
Younger
abstention is inapplicable when the administrative proceedings are remedial rather than coercive. Other circuits recognize a distinction between coercive and remedial actions and require exhaustion of state appellate remedies only in those that are coercive in nature.
See, e.g., Brown v. Day,
Determining whether a proceeding is coercive or remedial does not always lend itself to a clear-cut answer. For example, the divided Tenth Circuit panel in
Brown v. Day
disagreed whether the underlying Medicaid administrative proceeding involved in that case was coercive or remedial. The majority ruled that because the action had been initiated by the plaintiff to seek relief from the state’s allegedly unlawful conduct in terminating her Medicaid benefits, the proceeding was remedial rather than coercive.
Brown,
Although we have recognized the existence of the coercive-remedial distinction in other of our abstention cases,
see Planned Parenthood of Greater Iowa, Inc. v. Atchison,
Hudson’s case is procedurally identical to
McCartney,
in which the state of Nebraska denied Alleghany’s application for regulatory approval to buy stock in a Nebraska insurance company.
In
McCartney,
we required exhaustion of the state appellate remedies even in the absence of a pending state enforcement proceeding against the plaintiff, stating that “a party cannot avoid
Younger
by choosing not to pursue available state appellate remedies”
McCartney,
We turn to the question whether Missouri has an important state interest in administering its Medicaid program.
See Middlesex,
*989
Our final consideration is whether Hudson had an adequate opportunity at the state level to raise her constitutional questions.
See Middlesex,
III.
Because all three elements for Younger abstention are satisfied, we affirm the district court’s decision to abstain from exercising jurisdiction over Hudson’s claims.
Notes
. The Honorable Nanette K. Laughrey, United States District Judge for the Western District of Missouri.
. Greta Arlene Hudson passed away during this appeal, and her estate is now party to this action. We will refer to Hudson's estate as Hudson throughout this opinion.
.Whether Missouri law allows the State to withdraw from a hearing on its own motion is not before us on this appeal.
