Full opinion text
OPINION AND ORDER DENYING PLAINTIFFS’ MOTION TO CERTIFY CLASS, AND GRANTING DEFENDANTS’ MOTION TO DISMISS CLELAND, District Judge. I. Introduction In this case, Plaintiffs’ stated goal is to ensure that economically disadvantaged children throughout the State of Michigan obtain adequate medical care. The court can safely say that the endeavor is commendable. Having a virtuous goal in sight, however, does not endow a court with the power to hear a case, nor create a cause of action where none exists. In this case, neither jurisdiction nor a cause of action obtains. Plaintiffs seek injunctive relief and the appointment of a special master to end the State of Michigan’s (“Michigan” or “the State”) alleged systemic deprivation of Early and Periodic Screening, Diagnosis, and. Treatment Services (“EPSDT services”), which is part of the State’s Medicaid or “Medical Assistance” program. The named plaintiffs are two organizations, Families on the Move and Westside Mothers, and eight putative class representatives. The named defendants are two State officials purportedly responsible for administering Michigan’s EPSDT services; however, because the State of Michigan is the entity actually responsible for providing the contested EPSDT services, the court will refer to Michigan as the defendant. Plaintiffs bring their case under 42 U.S.C. § 1983, claiming that Michigan has failed to provide EPSDT services mandated by 42 U.S.C. § 1396, et seq., to the class of all Michigan children eligible for those services. On November 9, 1999, Michigan moved for dismissal or, alternatively, for summary judgment, which both parties then addressed in written briefs. On December 21, 1999, the court sua sponte ordered the parties to further address in briefing certain threshold issues not raised in the initial round of briefing pertaining to the nature of the relationship between the federal government and the State under the Medicaid program, the plaintiffs’ standing under § 1983 to bring suit against Michigan, and whether Michigan was legally amenable to suit. A second round of briefing ensued. Finding the State’s discussion of these issues to be less than fully satisfactory, the court invited and accepted the participation of the Michigan Municipal League (“the League”) as amicus curiae to address the issues raised by the court. Based upon the League’s participation, a third round of briefing occurred, culminating in a hearing on August 14, 2000. At the hearing, Michigan adopted all of the League’s arguments as its own, and the court will treat them as such in this order. Given the length and complexity of the matters considered, a summary of the Court’s opinion is in order. Plaintiffs’ suit raises, in essence, two threshold issues that must be addressed before the court may consider the merits of their claims. First, does the court have jurisdiction over this suit, which is directed in substance at the State of Michigan, an entity that is ordinarily immune from suit? Second, even if such jurisdiction exists, is there a cause of action permitting plaintiffs to sue in the State or its officers in order to enforce the rights asserted? The court’s review of these questions indicates that both are to be answered in the negative. The court’s analysis is organized as follows: Part II of this opinion provides an overview of the Medicaid EPSDT program at issue in this litigation. Part III explains the constitutional dimension of the Federal government’s and Michigan’s relationship under the Medicaid program, and why that relationship is necessarily contractual under the Constitution’s Spending Clause. In Part IV, the court explains that it lacks jurisdiction over this case because Michigan is the real defendants, and therefore possesses sovereign immunity against suit. Plaintiffs’ attempt to circumvent that immunity under the Ex parte Young by suing Michigan’s officers fails for at least four different reasons, each of which is separately explained. Even assuming that Ex parte Young was applicable to the instant case, Part V explains that § 1983 does not create a cause of action to sue states or their officers under Spending Power programs, and that the statute also does not operate as an independent means by which sovereign immunity may be overcome if Ex parte Young is unavailable. Three distinct reasons concerning the interpretation of § 1983 foreclose its use as envisioned by plaintiffs, and each is discussed in Part V. Plaintiffs’ assertions that the court’s analy-ses are foreclosed by prior jurisprudence concerning Spending Clause programs are addressed in Part VI; a handful of other issues are discussed in Part VII; and the court’s conclusion is found in Part VIII. II. Background The Supreme Court has described the Medicaid program at issue in this ■ litigation: [It] was created in 1965, when Congress added Title XIX to the Social Security Act, 79 Stat. 343, as amended, 42 U.S.C. § 1396 et seq. (1976 ed. and Supp. II) for the purpose of providing federal financial assistance to States that choose to reimburse certain costs of medical treatment for needy persons. Although participation in the Medicaid program is entirely optional, once a State elects to participate, it must comply with the requirements of Title XIX. Harris v. McRae, 448 U.S. 297, 301, 100 S.Ct. 2671, 65 L.Ed.2d 784 (1980). In other words, a State may either “complyf ] with the conditions set forth in the Act or forego[] the benefits of federal funding.” Pennhurst State Sch. and Hosp. v. Halderman, 451 U.S. 1, 11, 101 S.Ct. 1531, 67 L.Ed.2d 694 (1981) (internal citations omitted) (“Pennhurst I ”). The Act creates a “cooperative federal-state program” entitled “Grants to States for Medical Assistance Programs” to provide statutorily-authorized health care services to economically disadvantaged individuals. See 42 U.S.C. § 1396 et seq.; Wilder v. Virginia Hospital Ass’n, 496 U.S. 498, 502, 110 S.Ct. 2510, 110 L.Ed.2d 455 (1990). If a State elects to participate in the Medicaid program, it must submit to the Secretary of Health and Human Services (“HHS”) a state plan describing the scope of its medical assistance program, which will be administered by the State itself. See 42 U.S.C. § 1396a(b). Upon approval of the. plan, the Secretary allocates financial grants to help defray its cost. See 42 U.S.C. § 1396b; Harris, 448 U.S. at 308, 100 S.Ct. 2671. Michigan is authorized to participate in the Medicaid program pursuant to §§ 105-112e of the Michigan Social Welfare Act, M.C.L. §§ 400.105-400.112e. As previously mentioned, once a State agrees to participate in the Medicaid program, the requirements of Title XIX and the regulations promulgated thereunder become mandatory and binding upon the state. See Wilder, 496 U.S. at 502, 110 S.Ct. 2510; Boatman v. Hammons, 164 F.3d 286, 288 (6th Cir.1998) (citing 42 C.F.R. § 430.10 and Harris, 448 U.S. at 301, 100 S.Ct. 2671). A State’s plan must provide “assurance that [it] will be administered in conformity with the specific requirements of Title XIX, the regulations [promulgated thereunder] and other applicable official issu-ances of [HHS].” 42 C.F.R. § 430.10. Michigan’s “State Plan Under Title XIX of the Social Security Act,” includes such assurances of conformity. From time to time, Michigan submits plan amendments to the Secretary, as described at 42 C.F.R. § 430.12(c), to reflect changes in law or in the State’s operation of its Medicaid program. The Secretary retains the authority to monitor each participating State’s performance, and to terminate or limit payments to the state if the Secretary finds less than substantial compliance with any plan provision: [T]he Secretary shall notify such State agency that further payments will not be made to the State (or, in his discretion), that payments will be limited to categories under or parts of the State plan not affected by such failure, until the Secretary is satisfied that there will no longer be any such failure to comply. Until he is so satisfied he shall make no further payments to such State (or shall limit payments to categories under or parts of the State plan not affected by such failure). 42 U.S.C. § 1396c. The parties to the instant case agree that withholding funds from noncompliant states is the exclusive means by which the federal government may enforce the terms of the program, and that the federal government may not compel compliance through litigation.' Furthermore, the Medicaid statute contains no provision permitting Medicaid-eligible beneficiaries to bring suit against noncompli-ant states. There are, however, procedures that grant hearings to individuals who believe that they have been wrongfully denied care. To this end, every Medicaid provider in Michigan must incorporate an internal administrative grievance procedure as a condition of its contract with the State. Moreover, Michigan also maintains an administrative hearing mechanism by which Medicaid-eligible individuals can complain to a county department of social welfare about the quality or level of care provided. See M.C.L. §§ 400.37, 400.9. Those administrative decisions may be appealed to the county circuit court. See M.C.L. §§ 400.37. Turning to the actual services provided, a State’s agreement to participate in the Medicaid program obligates it to provide medical assistance to eligible individuals by paying for part or all of the costs of certain statutorily-enumerated medical services. See 42 U.S.C. §§ 1396, 1396d(a). The enumerated services for which the State must pay include EPSDT services, see 42 U.S.C. § 1396d(a)(4)(B), which are further defined at 42 U.S.C. § 1396d(r). Plaintiffs’ detailed, five-count complaint asserts that Michigan has failed, and continues to fail, to meet its mandatory EPSDT obligations under the Medicaid program, as set forth by statute, regulations, and HHS directives. To sum up plaintiffs’ complaints, they allege that Michigan has failed to ensure that Medicaid-eligible children in the State receive (1) EPSDT screening services required by 42 U.S.C. §§ 1396a(a)(43) and 1396d(r)(l)(A) and (B), 42 C.F.R. § 441.57, and various HHS policy directives; (2) EPSDT treatment services required by 42 U.S.C. § 1396d(r)(5) and 42 C.F.R. pt. 441; (3) basic child health care outreach and information required by 42 U.S.C. § 1396a(a)(43), 42 C.F.R. § 441.56, and various HHS policy directives; (4) assistance in scheduling EPSDT services as required by 42 U.S.C. § 1396a(a)(43)(b) and 42 C.F.R. § 441.62(b). Plaintiffs also allege that Michigan has (5) failed to secure capacity to deliver the EPSDT services required by Title XIX as mandated by 42 U.S.C. §§ 1396a(a)(8), 1396a(a)(30)(A) and 1396u-2(b)(5). Because the Medicaid statute itself does not contain a private cause of action, plaintiffs bring their complaint under 42 U.S.C. § 1983, alleging that the Michigan state officers purportedly responsible for implementing the State’s Medicaid program have acted and continue to act under color of state law to deprive plaintiffs of their clearly established rights under the federal Medicaid program. III. The Nature of the Relationship Between Michigan and the Federal Government Under the Medicaid Program It is a bedrock of constitutional law that the federal government is one of limited and enumerated powers. The Tenth Amendment enshrines this principle, and the Amendment itself reiterates that which is already obvious from the Constitution’s structure: “If a power is delegated to Congress in the Constitution, the Tenth Amendment expressly disclaims any reservation of that power to the States; if a power is an attribute of state sovereignty reserved by the Tenth Amendment, it is necessarily a power the Constitution has not conferred on Congress.” New York v. United States, 505 U.S. 144, 156, 112 S.Ct. 2408, 120 L.Ed.2d 120 (1992) (internal citations omitted). In fact, the Tenth Amendment “states but a truism that all is retained which has not been surrendered.” As Justice Story put it, “this amendment is a mere affirmation of what, upon any just reasoning, is a necessary rule of interpreting the constitution. Being an instrument of limited and enumerated powers, it follows irresistibly, that what is not conferred, is withheld, and belongs to the state authorities.” This has been the [Supreme] Court’s consistent understanding: “The states unquestionably do retain a significant measure of sovereign authority ... to the extent that the Constitution has not divested them of their original powers and transferred those powers to the Federal Government.” Id. (internal citations and punctuation omitted). No constitutional provisions exist that permit the federal government to require States or their officers to become instruments of federal policy. See Printz v. United States, 521 U.S. 898, 935, 117 5.Ct. 2365, 138 L.Ed.2d 914 (1997). “While Congress has substantial powers to govern the Nation directly, including in areas of intimate concern to the States, the Constitution has never been understood to confer upon Congress the ability to require the States to govern according to Congress’ instructions.” Neiv York, 505 U.S. at 162, 112 S.Ct. 2408 (internal citation omitted). As the Printz Court explained: The Framers’ experience under the Articles of Confederation had persuaded them that using the States as instruments of federal governance was both ineffectual and provocative of federal-state conflict. Preservation of the States as independent political entities being the price of union, and “the practicality of making laws, with coercive sanctions, for the States as political bodies” having been, in Madison’s words, “exploded on all hands,” the Framers rejected the concept of a central government that would act upon and through the States, and instead designed a system in which the State and Federal Governments would exercise concurrent authority over the people — who were, in Hamilton’s words, “the only proper objects of government.” We have set forth the historical record in more detail elsewhere, and need not repeat it here. It suffices to repeat the conclusion: “the Framers explicitly chose a Constitution that confers upon Congress the power to regulate individuals, not States.” The great innovation of this design was that our citizens would have two political capacities, one state and one federal, each protected from incursion by the other— a legal system unprecedented in form and design, establishing two orders of government, each with its own direct relationship, its own privity, its own set of mutual rights and obligations to the people who sustain it and are governed by it. The Constitution thus contemplates that a State’s government will represent and remain accountable to its own citizens. As Madison expressed it: “The local or municipal authorities form distinct and independent portions of the supremacy, no more subject, within their own spheres, to the general authority than the general authority is subject to them, within its own sphere.” Printz, 521 U.S. at 919-21, 117 S.Ct. 2365 (internal citations and punctuation omitted). Accordingly, while Congress can enact programs pursuant to its constitutionally enumerated powers and enforce them through federal officers, it cannot require the States to legislate pursuant to its directions, nor order the States to implement a solution to a congressionallydenoted problem. See Printz, 521 U.S. at 926, 117 S.Ct. 2365 (citing New York, 505 U.S. at 175-76, 188, 112 S.Ct. 2408). Nor can Congress achieve its otherwise legitimate aims by altogether ignoring State legislatures and dragooning State officers into becoming federal program administrators. See Printz, 521 U.S. at 928, 117 S.Ct. 2365. However, Congress can, as it has done with the Social Security retirement program, create a federal program implemented through federal officers that directly regulates individual behavior. But it cannot impress the States, either directly or though their officers, into the service of a federal program. Neither party to this case contests these basic propositions. Of course, the foregoing strictures do not prevent Congress from acting to influence the States’ behavior by means short of outright coercion. One such means, which is indisputably at the core of this litigation, is Congress’ ability to use its spending power as an incentive “by which [it] may urge a State to adopt a legislative program consistent with federal interests.” New York, 505 U.S. at 166, 112 S.Ct. 2408. As the Supreme Court has explained: The Constitution empowers Congress to “lay and collect Taxes, Duties, Imposts, and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States.” Art. I, § 8, cl. 1. Incident to this power, Congress may attach conditions on the receipt of federal funds, and has repeatedly employed the power to further broad policy objectives by conditioning receipt of federal moneys upon compliance by the recipient with federal statutory and administrative directives. South Dakota v. Dole, 483 U.S. 203, 206, 107 S.Ct. 2793, 97 L.Ed.2d 171 (1987) (internal citations and quotations omitted). In discussing the contours of Congress’ authority to legislate pursuant to the spending power, the Court has [l]ong recognized that Congress may fix the terms on which it shall distribute federal money to the States. Unlike legislation enacted under § 5 [of the Fourteenth Amendment], however, legislation enacted pursuant to the spending power is much in the nature of a contract: in return for federal funds, the States agree to comply with federally imposed conditions. The legitimacy of Congress’ power to legislate under the spending power thus rests on whether the State voluntarily and knowingly accepts the terms of the “contract.” There can, of course, be no knowing acceptance if a State is unaware of the conditions or is unable to ascertain what is expected of it. Accordingly, if Congress intends to impose a condition on the grant of federal moneys, it must do so unambiguously. By insisting that Congress speak with a clear voice, we enable the States to exercise their choice knowingly, cognizant of the consequences of them participation. Pennhurst I, 451 U.S. at 17, 101 S.Ct. 1531 (internal citations omitted). The Medicaid program at issue in this litigation is assuredly just such a contract. See, e.g., Pennhwrst I, 451 U.S. at 12-15, 101 S.Ct. 1531. While Congress possesses no power to order the Michigan legislature or Michigan officials to participate in the Medicaid program, it has offered financial incentives for them to do so. In return for federal funds, Michigan has agreed to adhere to the requirements set forth in federal statutes, regulations, and HHS directives. Justice Scalia’s concurrence on this topic in Blessing v. Freestone, 520 U.S. 329, 117 S.Ct. 1353, 137 L.Ed.2d 569 (1997) is illustrative of the legal relationships created under the Medicaid program. There, he explained that federal-state spending power programs are “much in the nature of a contract” because: The State promises to provide certain services to private individuals, in exchange for which the Federal Government promises to give the State funds. In contract law, when such an arrangement is made (A promises to pay B money, in exchange for which B promises to provides services to C), the person who receives the benefit of the exchange of promises between the two others (C) is called a third party beneficiary. Blessing, 520 U.S. at 349, 117 S.Ct. 1353 (Scalia, J. concurring). In short, the Medicaid program is a contract between Michigan and the Federal Government, and Medicaid recipients are third-party beneficiaries of that contract. However, as the previous excerpt from Pennhwrst I makes clear, all contract requirements must be unambiguous, and Michigan must have accepted them knowingly and voluntarily if there is to be any legally-cognizable expectation that it abide by them. Plaintiffs ardently object to the characterization of the Medicaid federal-state cooperative agreement as a “contract.” They note, correctly, that Pennhwrst I and its progeny refer to programs enacted pursuant to the spending power as being “in the nature of the contract.” The Court’s use of such qualified language instead of outrightly referring to such programs as “contracts”, they suggest, makes the term merely metaphorical. Plaintiffs posit that: [T]he Court is employing the poetic devices of analogy and simile to emphasize that, as in contract law, the statute must be clear as to what it requires and that participation by the State is voluntary. See Pennhwrst, 451 U.S. at 17, 101 S.Ct. 1531 (“by insisting that Congress speak with a clear voice, we enable the States to exercise their choice knowingly, cognizant of the consequences of their participation”). (Pl. Feb. 7, 2000 Br. at 6.) That such programs are “in the nature of a contract,” they argue, suggests that the Medicaid program is much in the nature of “something else” as well. According to plaintiffs, that “something else” is that the statute in question is a “law,” not a mere contract. But plaintiffs’ theory begs the question. No one disputes that the Medicaid program is authorized by federal statute. All laws enacted by Congress, however, are not of equal force. As previously explained, had Congress chosen to impose the Medicaid program directly on the citizenry as it did with the Social Security retirement program, participants could be compelled by law to conform with its strictures. But no such compulsion is available to the federal government when it chooses to act through the States. The participation of each sovereign is purely voluntary; indeed, as plaintiffs point out through their reliance on Pennhurst I, the agreement consists of no more than what the State unambiguously agrees to do. Were the arrangement binding “law” (the connotation presumably being the exercise of federal sovereign power under the Supremacy Clause), and not a contract, there would be no need for the State’s participation to be knowingly voluntary. Because the State’s participation in the Medicaid program is consensual and not compelled by the Constitution, it is contractual in nature. The significant variation from an ordinary contract results from the sovereign status of the parties, which limits the remedies each has against the other. Under ordinary contract law, if the parties to the contract were individuals, A could sue B for specific performance under some circumstances. Under the program at issue in this litigation, both parties agree that the federal government lacks any such power to sue Michigan for specific performance because the Medicaid statute does not provide that remedy. In other words, because the contract is between sovereigns and not individuals, the “contractual nature” of the relationship is more, not less, truncated that it would be in a purely private contract. Recognizing that it is the nature of the participants to this contract that forecloses the availability of certain remedies, the court must examine the Medicaid contract between the Federal Government and Michigan according to its overt terms to determine whether its third-party beneficiaries may sue Michigan for nonperformance. In all events, it is clear beyond cavil that for the judiciary to enforce against Michigan a federal program requirement that does not meet the Pennhurst I/South Dakota criteria would be to do that which the Constitution forbids: namely, conscript a State in furtherance of a federal policy without its consent, on the basis of a constitutionally unenumerated (and therefore nonexistent) congressional power. Congress may not force States into being its agents; Congress may offer incentives for the States to do so long as the requirements of the State’s participation are expressly set out. Derivative of the foregoing proposition, and of utmost importance for purposes of this litigation, is the notion that “‘the mere receipt of federal funds cannot establish that a State has consented to suit in federal court.’ ” Seminole Tribe, 517 U.S. at 59, 116 S.Ct. 1114 (quoting Atascadero State Hosp. v. Scanlon, 473 U.S. 234, 246-47, 105 S.Ct. 3142, 87 L.Ed.2d 171 (1985)). Recognizing these constitutional constraints, two crucial questions are posed: First, does the Medicaid program operate to waive Michigan’s sovereign immunity as a matter of constitutional law? This issue will be addressed in Part IV. Second, did Congress unambiguously condition its Medicaid funding contract with Michigan upon the State’s consenting to be sued by Medicaid beneficiaries? This issue will be addressed in PartV. IV. Whether Michigan and/or its Officers Retain Sovereign Immunity From Suit by Private Parties The Eleventh Amendment to the United States Constitution states: The Judicial power of the United States shall not be construed to extend to any suit in law or equity, commenced or prosecuted against one of the United States by Citizens of another State; or by Citizens or Subjects of any Foreign State. The Eleventh Amendment is understood “to stand not so much for what it says, but for the presupposition which it confirms.” Kimel v. Florida Bd. Of Regents, 528 U.S. 62, 120 S.Ct. 631, 640, 145 L.Ed.2d 522 (2000) (internal citations and punctuation omitted). Put simply, that presupposition is that “the Constitution does not provide for federal jurisdiction over suits against nonconsenting States.” Id. (internal citations omitted). “Even when the Constitution vests in Congress complete lawmaking authority over a particular area, the Eleventh Amendment prevents congressional authorization of suits by private parties against unconsenting States.” Id. at 643 (internal citations and quotations omitted). In particular, this absence of congressional power applies to the exercise of its enumerated powers under Article I, which means that Congress possesses no authority under Article I “to subject States to suit at the hands of private individuals.” Id. at 644. Because the Medicaid program at issue in the instant suit is an exercise of Congress’ Article I spending power, Congress may not unilaterally subject Michigan to suit by virtue of the State’s participation in the program. In other words, participation alone does not connote consent to suit. However, Michigan’s sovereign immunity from suit is not absolute. The Supreme Court has recognized two circumstances in which an individual may sue a State: First, Congress may authorize such a suit in the exercise of its power to eh-force the Fourteenth Amendment — an Amendment enacted after the Eleventh Amendment and specifically designed to alter the federal-state balance. Second, a State may waive its sovereign immunity by consenting to suit. College Sav. Bank v. Florida Prepaid Postsecondary Educ. Expense Bd., 527 U.S. 666, 119 S.Ct. 2219, 2223, 144 L.Ed.2d 605 (1999) (internal citations omitted). In this case, neither party asserts that Fourteenth Amendment abrogation is implicated. Whether Michigan has consented to suit is a more complicated question. As explained in Part III, supra, mere receipt of federal funds alone does not effectuate a waiver, and waiver of sovereign immunity pursuant to the Federal-State Medicaid contract occurs only if that condition is expressly stated as a contractual term. Michigan asserts that it has not waived its immunity here; but plaintiffs posit that Michigan’s acquiescence is irrelevant because plaintiffs sue not the State, but its officers, under the doctrine of Ex parte Young. The Young doctrine permits prospective injunctive relief against state officials in certain circumstances, even when the State itself is immune from suit. See Ex parte Young, 209 U.S. 123, 28 S.Ct. 441, 52 L.Ed. 714 (1908). As the Supreme Court explained, the doctrine applies in instances where: [a]n official claims to be acting under the •authority of the state. The act to be enforced is unconstitutional; and if it be so, the use of the name of the state to enforce an unconstitutional act to the injury of complainants is a proceeding without the authority of, and one which does not affect, the state in its sovereign or governmental capacity. It is simply an illegal act upon the part of the state official in attempting, by the use of the name of the state, to enforce a legislative enactment which is void because unconstitutional. If the act which the state [official] seeks to enforce be a violation of the Federal Constitution, the officer, in proceeding under such enactment, comes into conflict with the superior authority of that Constitution, and he is in that case stripped of his official or representative character and is subjected in his person to the consequences of his individual conduct. The státe has no power to impart to him any immunity from responsibility to the supreme authority of the United States. Id. at 159-60, 28 S.Ct. 441. Although Young itself concerned an alleged constitutional violation, the doctrine ordinarily also extends to violations of federal statutory law. See, e.g., Idaho v. Coeur d’Alene Tribe, 521 U.S. 261, 281, 117 S.Ct. 2028, 138 L.Ed.2d 438 (1997). The Young exception to State sovereign immunity is a “legal fiction” “adopted as necessary to permit the federal courts to vindicate federal rights and hold state officials responsible to ‘the supreme authority of the United States.’ ” Pennhurst State Sch. and Hosp. v. Halderman, 465 U.S. 89, 102-03, 105, 114 n. 25, 104 S.Ct. 900, 79 L.Ed.2d 67 (1984) (“Pennhurst II”) (citing Young, 209 U.S. at 160, 28 S.Ct. 441). As the Court explained in Green v. Mansour, 474 U.S. 64, 106 S.Ct. 423, 88 L.Ed.2d 371 (1985): [T]he availability of prospective relief of the sort awarded in Ex parte Young gives life to the Supremacy Clause. Remedies designed to end a continuing violation of federal law are necessary to vindicate the federal interest in assuring the supremacy of that law. Green, 474 U.S. at 68, 106 S.Ct. 423 (internal citations omitted). In other words, a state officer ostensibly acting under state law that contravenes the Constitution — or congressional enactments that are the supreme law of the land by dint of the Constitution’s Supremacy Clause — acts with no lawful authority at all. Where federal law is supreme, the states are powerless to authorize their officials to act in defiance of it. However, the Young doctrine is limited in its scope of available relief, and at most may permit a federal court to grant prospective injunctive relief against State officers who are violating supreme federal law. See Pennhurst II, 465 U.S. at 102-104, 104 S.Ct. 900 (internal citations omitted). Accordingly, the doctrine is available only where plaintiffs can demonstrate not only that a state official is violating federal law, but that the law in question is the supreme law of the land. In the instant case, the Ex parte Young doctrine is inapplicable for at least four reasons, which will be discussed hereafter. A. Spending Power Programs are Not the Supreme Law of the Land. The instant case falls outside the ambit of the Ex parte Young doctrine because the doctrine does not apply to congressional enactments under the Spending Power. As described in Part III, supra, such programs are contracts consensually entered into by the States with the Federal Government, and not statutory enactments by which States must automatically submit to federal prerogatives. To be sure, the Supreme Court has in the past held that federal-state cooperative programs enacted under the Spending Power fall within the ambit of the Supremacy Clause. See, e.g., Blum v. Bacon, 457 U.S. 132, 138, 145-46, 102 S.Ct. 2355, 72 L.Ed.2d 728 (1982); Carleson v. Remillard, 406 U.S. 598, 600, 92 S.Ct. 1932, 32 L.Ed.2d 352 (1972); Townsend v. Sivank, 404 U.S. 282, 285-86, 92 S.Ct. 502, 30 L.Ed.2d 448 (1971). In those cases, the Court asserted, without analysis, that the Supremacy Clause amounted to carte blanch authority for Congress to invalidate state laws, regardless of the source of the congressional power. In more recent years, however, the Supreme Court has conducted a more searching analysis of the nature and extent of the Supremacy Clause. In Alden v. Maine, 527 U.S. 706, 119 S.Ct. 2240, 144 L.Ed.2d 636 (1999), the Court analyzed the scope of the Supremacy Clause, and held that: As is evident from its text ... the Supremacy Clause enshrines as “the supreme Law of the Land” only those federal Acts that comport with the constitutional design. Appeal to the Supremacy Clause alone merely raises the question whether a law is a valid exercise of the national power. See The Federalist No. 33, at 204 (A. Hamilton) (“But it will not follow from this doctrine that acts of the larger society which are not pursuant to its constitutional powers, but which are invasions of the residuary authorities of the smaller societies, will become the supreme law of the land”). Id. at 2254 (internal citations omitted). As the Court earlier noted in Printz, a reliance on the Supremacy Clause as the source of federal authority “merely brings us back to the question” of whether Congress has the enumerated authority in the first instance to enact that which is asserted to be supreme. Printz, 521 U.S. at 924-25, 117 S.Ct. 2365. Put another way, federal law cannot be supreme in an area in which Congress lacks an enumerated power to legislate. See also Gregory, 501 U.S. at 460, 111 S.Ct. 2395 (“As long as it is acting within the poivers granted to it by the Constitution, Congress may impose its will on the States [under the Supremacy Clause].”) (emphasis added). As discussed in Part III, supra, the enumerated power under which Congress acted when it created the Medicaid statute is the Spending Power. Congress has no power to compel the States to participate in voluntary federal programs like Medicaid. If a State chooses to participate in the program, it certainly must comply with program requirements in order to continue to receive the allotted federal funds, “[b]ut the authority to require compliance with participation standards is derived not from the primacy of federal law enacted pursuant to an enumerated power but from the terms of a contract and the agreement to abide by those terms in return for the receipt of federal moneys.” Brogdon v. National Healthcare Corp., 103 F.Supp.2d 1322, 1339 (N.D.Ga.2000) (citing Pennhurst I, 451 U.S. at 17, 101 S.Ct. 1531). The Supremacy Clause does not operate upon a State or its officers when Congress enacts a program such as Medicaid pursuant to the Spending Power because neither the Spending Power nor any other Article I power grants Congress the authority to compel State action. The relationship between the Federal and State governments in Spending Power programs is merely one of mutual acquiescence. That Congress may (either directly or through delegation to the HHS Secretary) pass Medicaid laws that are inconsistent with state laws pertaining to the same subject does not render those state statutes void; the Federal government must rely on its power of the purse to seek State compliance with Federal program objectives. See, e.g., Brogdon, 103 F.Supp.2d at 1339 (noting that congressional enactments under the Spending Power do not preempt State law) (citing United States v. Morrison, 529 U.S. 598, 120 S.Ct. 1740, 1754, 146 L.Ed.2d 658 (2000)). Spending Power enactments do not constitute the “supreme authority of the United States,” a point made clear by the Court’s holdings in Alden, Printz, New York, South Dakota, and Pennhurst I. By way of example, if Michigan chose not to participate in the Medicaid program, but instead ran a similar program using its own funds under its own guidelines, Michigan’s guidelines would not be preempted by the competing federal Medicaid program, because a State’s .participation in Medicaid is entirely volitional. The situation is identical here because the Constitution grants the Federal Government no power of compulsion under the Spending Clause; Michigan and the Federal government are on equal constitutional footing, and neither has any power to compel the other. The Court has adopted the view espoused by Chief Justice Burger in Townsend, which is that Spending Power enactments are “in no way mandatory upon the States under the Supremacy Clause;” States may either comply with the federal requirements, or forego the benefit of the bargain. Townsend, 404 U.S. at 292, 92 S.Ct. 502 (Burger, C.J., concurring) (internal citation omitted). For this court to hold otherwise would be to do that which Hamilton warned against in Federalist 33, namely, to invade Michigan’s residual authority by enforcing as the supreme law of the land federal legislation that the Constitution does not make supreme. Because congressional enactments pursuant to the Spending Power that set forth the terms of federal-state cooperative agreements depend on the voluntary agreement of participating States and are not within the ambit of the Supremacy Clause, they are not the supreme law of the land, and suits cannot be brought against state officials under Ex parte Young to enforce those requirements. B. The State is the Real Party in Interest When Its Officers Act Within Their Lawful Authority. By virtue of the Young doctrine, sovereign immunity does not bar all suits against state officers. However, “[sjome suits against state officers are barred by the rule that sovereign immunity is not limited to suits which name the State as a party if the suits are, in fact, against the State.” Alden, 119 S.Ct. at 2267 (citing In re Ayers, 123 U.S. 443, 505-06, 8 S.Ct. 164, 31 L.Ed. 216 (1887); Idaho, 521 U.S. at 270, 117 S.Ct. 2028 (explaining that “[t]he real interests served by the Eleventh Amendment are not to be sacrificed to elementary mechanics of captions and pleadings.”)). Construing Young as permitting suit against state officials for all alleged State violations of federal law would render the doctrine of sovereign immunity meaningless. See Idaho, 521 U.S. at 269, 117 S.Ct. 2028. As the Idaho Court observed: When suit is commenced, against state officials, even if they are named and served as individuals, the State itself will have a continuing interest in the litigation whenever state policies or procedures are at stake. This commonsense observation of the State’s real interest when its officers are named as individuals has not escaped notice or comment from the Court, either before or after Young. See, e.g., Osborn v. Bank of United States, 9 Wheat. 738, 846-47, 6 L.Ed. 204 (1824) (stating that the State’s interest in the suit was so “direct” that “perhaps no decree ought to have been announced in the cause, until the State was before the court”) (Marshall, C.J.); Pennhurst II, 465 U.S. at 114 n. 25, 104 S.Ct. 900 (noting that Young rests on a fictional distinction between the official and the State)[.] ... Indeed, the suit in Young, which sought to enjoin the state attorney general from enforcing state law, implicated substantial state interests. 209 U.S. at 174, 28 S.Ct. 441 (“[T]he manifest, indeed the avowed and admitted, object of seeking [the requested] relief [is] to tie the hands of the State”) (Harlan, J., dissenting). We agree with those observations. To interpret Young to permit a federal-court action to proceed in every case where prospective declaratory and in-junctive relief is sought against an officer, named in his individual capacity, would be to undermine the principle, reaffirmed just last Term in Seminole Tribe, that Eleventh Amendment immunity represents a real limitation on a federal court’s federal question jurisdiction .... Application of the Young exception must reflect a proper understanding of its role in our federal system and respect for state courts instead of a reflexive reliance on an obvious fiction. See, e.g. Pennhurst II, supra, at 102-03, 114 n. 25, 104 S.Ct. 900 (explaining that the limitation in Edelman v. Jordan, 415 U.S. 651, 94 S.Ct. 1347, 39 L.Ed.2d 662 (1974), of Young to prospective injunc-tive relief represented a refusal to apply the fiction in every conceivable circumstance). Idaho, 521 U.S. at 269-270, 117 S.Ct. 2028. The instant plaintiffs correctly note that Ex parte Young suits have been brought repeatedly over at least the past thirty years against state officers for alleged non-compliance with federal-state programs enacted pursuant to the Spending Power. Indeed, the Court’s opinion in Young permitting some kinds of suits against state officials relied extensively upon its prior opinion in In re Ayers, which extensively discussed the circumstances under which state officers could or could not be sued. See, generally, Young, 209 U.S. 123, 28 S.Ct. 441, 52 L.Ed. 714 (citing Ayers, 123 U.S. 443, 8 S.Ct. 164, 31 L.Ed. 216). Rather than merely paraphrasing the Court’s analysis in Ayers to discuss the suitability of such suits, the court believes it more beneficial to quote directly, though at some length, the Ayers decision. First: It must be regarded as the settled doctrine of this court, established by its recent decisions, “that the question whether a suit is within the prohibition of the Eleventh Amendment is not always determined by reference to the nominal parties on the record.” Poindexter v. Greenhow, 114 U.S. 270, 287, 5 S.Ct. 903, 29 L.Ed. 185 (1885). Ayers, 123 U.S. at 487, 8 S.Ct. 164. Noting at the outset that this assertion appeared to be in dishaimony with Chief Justice Marshall’s opinion in Osborn v. Bank, 9 Wheat. 738, 857, 6 L.Ed. 204 (1824), in which the Chief Justice wrote that the party named in the pleadings was controlling for purposes of sovereign immunity analysis, the Ayers Court quoted Marshall’s opinion further, which stated that: “The state not being a party on the record, and the court having jurisdiction over those who are parties on the record, the true question is not one of jurisdiction, but whether, in the exercise of its jurisdiction, the court ought to make a decree against the defendants,— whether they are to be considered as having a real interest, or as being only nominal parties.” Ayers, 123 U.S. at 488, 8 S.Ct. 164 (quoting Osborn, 9 Wheat, at 858, 6 L.Ed. 204). In light of Chief Justice Marshall’s caveat, the Ayers Court held Osborn to mean that: [w]here the defendants, who are sued as officers of the state, have not a real, but merely a nominal, interest in the controversy, the state appearing to be the real defendant, and therefore an indispensable party, if the jurisdiction does not fail for want of power over the parties, it does fail as to the nominal defendants, for want of a suitable subject-matter. Ayers, 123 U.S. at 488, 8 S.Ct. 164. Writing for the Court in Governor of Georgia v. Madrazo, 1 Pet. 110, 7 L.Ed. 73 (1828), a post-Oshom case, Chief Justice Marshall appeared to adopt the interpretation Ayers was to later make of his Osborn opinion. Relying on Osborn, the Madrazo Court held that: “[wjhere the chief magistrate of a state is sued, not by his name, but by his style of office, and the claim made upon him is entirely in his official character, we think the state itself may be considered a party on the record. If the state is not a party, there is no party against whom a decree can be brought. No person in his natural capacity is brought before the court as defendant.” Ayers, 123 U.S. at 489, 8 S.Ct. 164 (quoting Madrazo, 1 Pet. at 123-24, 7 L.Ed. 73). The Ayers Court continued its analysis: It was therefore held, [in Madrazo ], that the state was in fact, though not in form, a party defendant to the suit, and that, consequently, the circuit court had no jurisdiction to pronounce the decree appealed from[;] ... Accordingly, in Cunningham v. Railway Co., 109 U.S. 446, 3 S.Ct. 292, 27 L.Ed. 992 (1883), it was decided that in those cases where it is clearly seen upon the record that the state is an indispensable party to enable the court, according to the rules which govern its procedure, to grant the relief sought, it will refuse to take jurisdiction. The inference is that where it is manifest, upon the face of the record, that the defendants have no individual interest in the controversy, and that the relief sought against them is only in their official capacity as representatives of the state, which alone is to be affected by the judgment or decree, the question then arising, whether the suit is not substantially a suit against the state, is one of jurisdiction. Ayers, 123 U.S. at 489, 8 S.Ct. 164. The Ayers Court went on to analyze the import of its post-Madrazo decision in Hagood v. Southern, 117 U.S. 52, 6 S.Ct. 608, 29 L.Ed. 805 (1886): [In Hagood,] the state of South Carolina, which was the party in interest, was not nominally a defendant. The nominal defendants were the treasurer of the state of South Carolina, its comptroller general, and the treasurers of its various counties and their successors in office. The object of the bills was to obtain on behalf of the complainants, by judicial process, the redemption by the state of certain scrip of which they were holders, according to the terms of a statute in pursuance of which it was issued, by the levy, collection, and appropriation of a special tax pledged to that purpose, as they claimed, by an irrepealable law constituting a contract protected from violation by the Constitution of the United States. The decrees of the circuit court granting the relief were-reversed, and the case remanded, with instructions to dismiss the bills, on the ground that the suits, though nominally against the officers of the state, were really against the state itself. In its opinion this court said, “These suits are accurately described as bills for the specific performance of a contract between the complainants and the state of South Carolina, who are the only parties to it. But to these bills the state is not in name made a party defendant, though leave is given to it to become such if it chooses; and except with that consent it could not be brought before the court, and be made to appear and defend. And yet it is the actual party to the alleged contract, the performance of which is decreed, the one required to perform the decree, and the only party by whom it can be performed. Though not nominally a party to the record, it is the real and only party in interest, the nominal defendants being the officers and agents of the state, having no personal interest in the subject matter of the suit, and defending only as representing the state. And the things required by the decrees to be done and performed by them are the very things which, when done and performed, constitute a performance of the alleged contract by the state. The state is not only the real party to the controversy, but the real party against which relief is sought by the suit, and the suit is therefore substantially within the prohibition of the Eleventh Amendment to the Constitution of the United States.” Hagood, 117 U.S. at 67, 6 S.Ct. 608. The conclusions in the case of Hagood v. Southern were justified by what had previously been decided by this court in the cases of Louisiana v. Jumel and Elliott v. Wiltz, 107 U.S. 711, 2 S.Ct. 128, 27 L.Ed. 448 (1882)[ (which were decided in one opinion) ]. Those cases had for their object, one, by injunction, to restrain the officers of the state from executing the provisions of the act of the general assembly alleged to be in violation of the contract rights of the plaintiffs, and the other, by mandamus, to require the appropriation of money from the treasury of the state in accordance with the contract. This relief, it was decided, was not within the competency of the judicial power. The Chief Justice said, on that point, “The remedy sought, in order to be complete, would require the court to assume all of the executive authority of the state, so far as it was related to the enforcement of this law, and to supervise the conduct of all persons charged with any official duty in respect to the levy, collection, and disbursement of the tax in question until the bonds, principal and interest, were paid in full; and that, too, in a proceeding in which the state, as a state, was not and could not be made a party. It needs no argument to show that the political power cannot be thus ousted of its jurisdiction, and the judiciary set in its place. When a state submits itself, without reservation, to the jurisdiction of the court in a particular case, that jurisdiction may be used to give full effect to what the state has, by its act of submission, allowed to be done; and if the law permits the coercion of the public officers to enforce any judgment that may be rendered, then such coercion may be employed for that purpose. But this is very far from authorizing the court, when a state cannot be sued, to set up its jurisdiction over the officers in charge of the public moneys, so as to control them as against the political power, in their administration of the finances of the state.” Louisiana, 107 U.S. at 727, 2 S.Ct. 128. Ayers, 123 U.S. at 490-92, 8 S.Ct. 164. In short, the Ayers Court held that plaintiffs could not circumvent a State’s sovereign immunity from suit by naming as defendants the officers charged' with carrying out the State’s alleged delinquent responsibilities. Elaborating further, and using the analysis later relied upon in Ex Parte Young, the Court delineated the circumstances under which state officers might be sued: [The Ayers plaintiffs who are suing Virginia officers for the state’s alleged contractual breach do not] allege any grounds of equitable relief against the individual defendants for any personal wrong committed or threatened by them. It does not charge against them in their individual character anything done or threatened which constitutes, in contemplation of law, a violation of personal or property rights, or a breach of contract to which they are parties.' The relief sought is against the defendants, not in their individual but in their representative capacity, as officers of the state of Virginia. The acts sought to be restrained are the bringing of suits by the state of Virginia in its own name, and for its own use. If the state had been made a defendant to this bill by name, charged according to the allegations it now contains, — supposing that such a suit could be maintained, — it would have been subjected to the jurisdiction of the court by process served upon its governor and attorney general, according to the precedents in such cases. If a decree could have been rendered enjoining the state from bringing suits against its taxpayers, it would have operated upon the state only through the officers who by law were required to represent it in bringing such suits, viz., the present defendants, its attorney general, and the commonwealth’s attorneys for the several counties. For a breach of such an injunction, these officers would be amenable to the court as proceeding in contempt of its authority, and would be liable to punishment therefor by attachment and imprisonment. The nature of the case, as supposed, is identical with that of the case as actually presented in /the bill with the single exception that the state is not named as a defendant. How else can the state be forbidden by judicial process to bring actions in its name, except by constraining the conduct of its officers, its attorneys, and its agents? And if all such officers, attorneys, and agents are personally subjected to the process of the court, so as to forbid their acting in its behalf, how can it be said that the state its'elf is not subjected to the jurisdiction of the court as an actual and real defendant? It is, however, insisted upon in argument that it is within the jurisdiction of the circuit court of the United States to restrain by injunction officers of the states from executing the provisions of state statutes void by reason of repug-nancy to the Constitution of the United States; that there are many precedents in which that jurisdiction has been exercised under the sanction of this court; and that the present case is covered by their authority. Ayers, 123 U.S. at 497-98, 8 S.Ct. 164 (internal citations omitted). But the precedents referred to, in which the Court permitted state officers to be sued were: [ajdjudged not to be a suit against the state, and not to be one in which the state was a necessary party, [and the rationale permitting suit] was that the defendants personally and individually were wrong-doers, against whom the complainants had a clear right of action for the recovery of the property taken, or its value, and that, therefore, it was a case in which no other parties were necessary. The right asserted and the relief asked were against the defendants as individuals. They sought to protect themselves against personal liability by their official character as representatives of the state. This they were not permitted to do, because the authority under which they professed to act was void. The vital principle in all such cases is that the defendants, though professing to act as officers of the state, are threatening a violation of the personal or property rights of the complainant, for which they are personally and individually liablef.] ... “A defendant sued as a wrong-doer, who seeks to substitute the state in his place, or to justify by the authority of the state, or to defend on the ground that the state has adopted his act and exonerated him, cannot rest on the bare assertion of his defense. He is bound to establish it. The state is a political corporate body, can only act through its agents, and can command only by laws. It is necessary, therefore, for such a defendant, in order to complete his defense, to produce a law of the state which constitutes his commission as its agent and a warrant for his act[.]” ... The legislation under which the defendant justified, being declared to be null and void, as contrary to the Constitution of the United States, therefore left him defenseless, subject to answer to the consequences of his personal act .. □ Ayers, 123 U.S. at 500-01, 8 S.Ct. 164 quoting Poindexter v. Greenhow, 114 U.S. at 288, 5 S.Ct. 903. A state officer can claim to be acting as the agent of the State only where such authority has been conferred by law. See Ayers, 123 U.S. at 501, 8 S.Ct. 164 (citing United States v. Lee, 106 U.S. 196, 1 S.Ct. 240, 27 L.Ed. 171 (1882)). The Ayers Court went on to explain that the question of whether a state officer possesses lawful authority is a feature that: [will be found, on an examination, to characterize every case where persons have been made defendants for acts done or threatened by them as officers of the government, either of a state or of the United States, where the objection has been interposed that the state was the real defendant, and has been overruled. The action has been sustained only in those instances where the act complained of, considered apart from the official authority alleged as its justification, and as the personal act of the individual defendant, constituted a violation of right for which the plaintiff was entitled to a remedy at law or in equity against the wrong-doer in his individual character. Ayers, 123 U.S. at 501-02, 8 S.Ct. 164. Utilizing the analysis to later be relied upon in Young, the Court explicated the circumstances under which Eleventh Amendment sovereign immunity poses no bar to suits against state officers acting under color of authority for violations of federal rights: The government of the United States, in the enforcement of its laws, deals with all persons within its territorial jurisdiction as individuals owing obedience to its authority. The penalties of disobedience may be visited upon them without regard to the character in which they assume to act, or the nature of the exemption they may plead in justification. Nothing can be interposed between the individual and the obligation he owes to the Constitution and laws of the United States, which can shield or defend him from their just authority, and the extent and limits of that authority the government of the United States, by means of its judicial power, interprets and applies for itself. If therefore, an individual, acting under the assumed authority of a state, as one of its officers, and under color of its laws, comes into conflict with the superior authority of a valid law of the United States, he is stripped of his representative character, and subjected in his person to the consequences of his individual conduct. The state has no power to impart to him any immunity from responsibility to the supreme authority of the United States. Ayers, 123 U.S. at 507, 8 S.Ct. 164. Reiterating its analyses under the facts presented by Ayers, see id. at 502-04, 8 S.Ct. 164, the Court came to the identical conclusion found in the precedents it relied upon: [Wjhere the contract is between the individual and the state, no action will lie against the state, and any action founded upon it against defendants who are officers of the state, the object of which is to enforce its specific performance by compelling those things to be done by the defendants which, when done, would constitute a performance by the state, or forbid the doing of those things which, if done, would merely be breaches of the contract of the state, is in substance a suit against the state itself, and equally within the prohibition of the Constitution. It cannot be doubted that the Eleventh Amendment to the Constitution operates to create an important distinction between contracts of a state with individuals and contracts between individual parties[.] ... [B]y virtue of the Eleventh Amendment to the Constitution, there being no remedy by a suit against the state, the contract is substantially without sanction, except that which arises out of the honor and good faith of the state itself, and these are not subject to coercion. Although the state may, at the inception of the contract, have consented as one of its conditions to subject itself to suit, it may subsequently withdraw that consent, and resume its original immunity, without any violation of the obligation of its contract in the constitutional sense. The very object and purpose of the Eleventh Amendment were to prevent the indignity of subjecting a state to the coercive process of judicial tribunals at the instance of private parties. It was thought to be neither becoming nor convenient that the several states of the Union, invested with that large residuum of sovereignty which had not been delegated to the United States, should be summoned as defendants to answer to complaints of private persons ... or that the course of their public policy and the administration of their public affairs should be subject to and controlled by the mandates of judicial tribunals, without their consent, and in favor of individual interests. To secure the manifest purposes of the constitutional exemption guaranteed by the Eleventh Amendment; requires that it should be interpreted, not literally and too narrowly, but fairly, and with such breadth and largeness as effectually to accomplish the substance of its purpose. In this spirit it must be held to cover, not only suits brought against a state by name, but those also brought against its officers, agents, and representatives, where the state, though not named as such, is, nevertheless, the only real party against which alone in fact the relief is asked, and against which the judgment or decree effectively operates. Ayers, 123 U.S. at 504-06, 8 S.Ct. 164 (internal citations omitted). It bears repeating that the Ayers decision is the basis of the Court’s holding in Ex parte Young, and that Ayers has been recently reaffirmed in Idaho and Alden. The applicability of state sovereign immunity to state officers, and the corresponding narrowness of the Young exception were also mor