Health and Hospital Corporation of Marion Cty. v. Talevski

P R E L I M I N A R Y P R I N T
Volume 599 U. S. Part 1
Pages 166–235
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T H E S U P R E M E C O U R T
June 8, 2023
REBECCA A. WOMELDORF
reporter of decisions
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166 OCTOBER
TERM, 2022
Syllabus
HEALTH AND HOSPITAL CORPORATION OF MARION
COUNTY
et al. v. TALEVSKI, as personal repre-
sentative of the ESTATE OF TALEVSKI
certiorari to the united states court of appeals for
the seventh circuit
No. 21–806. Argued November 8, 2022—Decided June 8, 2023
After Gorgi Talevski's move to a nursing home in 2016 proved problematic,
Talevski (through his wife Ivanka) brought an action under 42 U. S. C.
§ 1983 against a county-owned nursing home and its agents (collectively,
HHC), claiming that HHC's treatment of Talevski violated rights guar-
anteed him under the Federal Nursing Home Reform Act (FNHRA).
The District Court granted HHC's subsequent motion to dismiss Talev-
ski's complaint, reasoning that no plaintiff can enforce provisions of the
FNHRA via § 1983. The Seventh Circuit reversed, concluding that the
rights referred to in two FNHRA provisions invoked by Talevski—the
right to be free from unnecessary chemical restraints, see § 1396r(c)(1)
(A)(ii), and rights to be discharged or transferred only when certain
preconditions are met, see § 1396r(c)—“unambiguously confer individu-
ally enforceable rights on nursing-home residents,” making those rights
presumptively enforceable via § 1983. 6 F. 4th 713, 720. The Seventh
Circuit further found nothing in the FNHRA to indicate congressional
intent to foreclose § 1983 enforcement.
Held: The FNHRA provisions at issue unambiguously create § 1983-
enforceable rights, and the Court discerns no incompatibility between
private enforcement under § 1983 and the remedial scheme that Con-
gress devised. Pp. 174–192.
(a) Section 1983 has, since the 1870s, provided an express cause of
action to any person deprived (by someone acting under color of state
law) of “any rights . . . secured by the Constitution and laws.” The
Court has long refused to read § 1983's unmodifed term “laws” to mean
only some of the laws. Maine v. Thiboutot, 448 U. S. 1, 6. Looking
to history, HHC attempts to sow doubt about § 1983's textually unquali-
fed sweep, and proffers a Spending Clause-based argument to narrow
§ 1983's meaning. But a fuller picture of the relevant history lends
HHC no aid.
The Court is unpersuaded by HHC's argument that, because Congress
seems to have enacted the FNHRA pursuant to the Spending Clause,
Talevski cannot invoke § 1983 to vindicate rights recognized by the
FNHRA. HHC starts with the Court's observation that federal legis-
lation premised on the Spending Clause power is “much in the nature

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as: 599 U. S. 166 (2023)
167
Syllabus
of a contract,” Pennhurst State School and Hospital v. Halderman, 451
U
. S. 1, 17. From there, HHC argues that Spending Clause statutes
may not be enforced via § 1983 because contracts were not generally
enforceable by third-party benefciaries when § 1983 was enacted in the
1870s. The Court rejects HHC's argument. First, while the Court
has reasoned that Congress's failure to displace frmly rooted common-
law principles generally indicates that it incorporated those established
principles into § 1983, Wyatt v. Cole, 504 U. S. 158, 163–164, HHC's key
common-law plank here—that third-party benefciaries could not sue to
enforce contractual obligations during the relevant time—is, at a mini-
mum, contestable. “[S]omething more than `ambiguous historical evi-
dence' is required [to] `fatly overrule a number of major decisions of this
Court,' ” Gamble v. United States, 587 U. S. –––, –––. Second, because
“[t]here is no doubt that the cause of action created by § 1983 is, and
was always regarded as, a tort claim,” Monterey v. Del Monte Dunes
at Monterey, Ltd., 526 U. S. 687, 727 (Scalia, J., concurring in part and
concurring in judgment), HHC's focus on 1870s law governing third-
party-benefciary suits in contract is perplexing, and HHC offers no rea-
son those principles should be read to displace the plain scope of “laws”
in § 1983. Pp. 174–180.
(b) Under the Court's precedent, the FNHRA provisions at issue here
unambiguously confer individual federal rights enforceable under § 1983,
and the Court discerns no intent by Congress in the FNHRA to pre-
clude private enforcement of these rights under § 1983. Pp. 180–192.
(1) Although federal statutes have the potential to create § 1983-
enforceable rights, they do so under this Court's precedents only when
the statute unambiguously confers those rights. The Court has recog-
nized that the typical remedy for noncompliance with a federal statute
enacted pursuant to the Spending Clause is not a private cause of action
for noncompliance but rather termination of funds to the State. See
Gonzaga Univ. v. Doe, 536 U. S. 273, 280. The parties here thus dispute
whether this is the atypical case; that is, whether the unnecessary-
restraint and predischarge-notice provisions of the FNHRA “unambigu-
ously confe[r]” individual rights, making those rights “presumptively
enforceable” under § 1983. Id., at 283–284.
Gonzaga sets forth the Court's established method for ascertaining
unambiguous conferral. Courts must employ traditional tools of statu-
tory construction to assess whether Congress has “unambiguously con-
ferred” “individual rights upon a class of benefciaries” to which the
plaintiff belongs. Id., at 283, 285–286. Notably, it must be determined
that “Congress intended to create a federal right” for the identifed
class, not merely that the plaintiffs fall “within the general zone of inter-
est that the statute is intended to protect.” Id., at 283 (emphasis de-
leted). The test for unambiguous conferral is satisfed where the provi-

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168 HEAL
TH AND HOSPITAL CORPORATION OF MARION
CTY. v. TALEVSKI
Syllabus
sion in question is “ `phrased in terms of the persons benefted' ” and
cont
ains “rights-creating,” individual-centric language with an “ `unmis-
takable focus on the benefted class.' ” Id., at 284, 287 (emphasis de-
leted). If a statutory provision surmounts this signifcant hurdle, it
“secures” individual rights that are deemed “presumptively enforceable”
under § 1983. Id., at 284.
The unnecessary-restraint and predischarge-notice provisions in
the FNHRA that Talevski's complaint invokes meet this test. The
FNHRA lays out a litany of statutory “[r]equirements relating to resi-
dents' rights,” § 1396r(c). The unnecessary-restraint provision requires
nursing facilities to “protect and promote” residents' “right to be free
from . . . any physical or chemical restraints . . . not required to treat the
resident's medical symptoms.” § 1396r(c)(1)(A)(ii). The predischarge-
notice provision imposes preconditions that a nursing facility must meet
to “transfer or discharge [a] resident.” §§ 1396r(c)(2)(A)–(B). Both
provisions reside in § 1396r(c), which expressly concerns “[r]equirements
relating to residents' rights.” Ibid. (emphasis added). This framing is
indicative of an individual “rights-creating ” focus. Gonzaga, 536 U. S.,
at 284. That these two provisions also establish who must comply with
these statutory rights (namely, the Medicaid-participant nursing homes)
does not dispel the statute's focus on the nursing-home residents, i. e.,
the benefted class. The provisions use clear “rights-creating lan-
guage,” speak “ `in terms of the persons benefted,' ” and have an “ `un-
mistakable focus on the benefted class.' ” Id., at 284, 287, 290 (empha-
sis deleted). Thus, they satisfy Gonzaga's stringent standard, and the
rights they recog nize are presumptively enforceable under § 1983.
Pp. 180–186.
(2) Even if a statutory provision unambiguously secures rights, a
defendant “may defeat [the] presumption by demonstrating that Con-
gress did not intend” that § 1983 be available to enforce those rights.
Rancho Palos Verdes v. Abrams, 544 U. S. 113, 120. Evidence of such
intent may be found expressly in the statute creating the right, or im-
plicitly, by creating “a `comprehensive enforcement scheme that is in-
compatible with individual enforcement under § 1983,' ” ibid. Here, the
Court fnds evidence of neither. The FNHRA establishes a detailed
admi nistrative scheme for i nspec ti ons of nursi ng faci lities, see
§ 1396r(g), and authorizes governments to sanction and correct noncom-
pliant facilities, see § 1396r(h). But the statute lacks any indicia of con-
gressional intent to preclude § 1983 enforcement, such as an express
private judicial right of action or any other provision that might signify
that intent. HHC focuses on comprehensiveness of the FNHRA's en-
forcement mechanisms, but implicit preclusion is shown only by a “ `com-
prehensive enforcement scheme that is incompatible with individual en-
forcement under § 1983.' ” Fitzgerald v. Barnstable School Comm., 555

Cite
as: 599 U. S. 166 (2023)
169
Syllabus
U. S. 246, 252 (emphasis added). The Court's prior cases fnding implicit
preclusi
on involved statutes where private enforcement under § 1983
would have thwarted Congress's scheme by circumventing the statutes'
presuit procedures, or by giving plaintiffs access to tangible benefts
otherwise unavailable under the statutes construed. HHC has identi-
fed no equivalent sign of incompatibility in the FNHRA, which lacks a
private judicial right of action, a private federal administrative remedy,
or any “ `carefu[ l]' ” congressional “ `tailor[ing],' ” id., at 255, that § 1983
actions would “distort,” Rancho Palos Verdes, 544 U. S., at 127. Fi-
nally, the Court rejects any speculation that because Congress knew
most nursing homes are private entities not subject to suit under § 1983,
the FNHRA's remedial scheme “necessarily refects Congress's judg-
ment that these administrative enforcement mechanisms appropriately
protect the rights the statute confers,” Brief for United States as Ami-
cus Curiae 31. The focus in the implicit-preclusion inquiry remains
whether something in the FNHRA has foreclosed § 1983's “genera[ l]”
availability as “a remedy for the vindication of rights secured by federal
statutes.” Gonzaga, 536 U. S., at 284. The Court sees no such sign,
much less a license for the Court to construct and impute to Congress
an intent that the FNHRA does not embody. Pp. 186–192.
6 F. 4th 713, affrmed.
Jackson, J., delivered the opinion of the Court, in which Roberts, C. J.,
and Sotomayor, Kagan, Gorsuch, Kavanaugh, and Barrett, JJ.,
joined. Gorsuch, J., fled a concurring opinion, p. 192. Barrett, J.,
fled a concurring opinion, in which Roberts, C. J., joined, p. 193.
Thomas, J., fled a dissenting opinion, p. 196. Alito, J., fled a dissenting
opinion, in which Thomas, J., joined, p. 230.
Lawrence S. Robbins argued the cause for petitioners.
With him on the briefs were Carolyn M. Forstein, Jeffrey C.
Fourmaux, and Anil K. Vassanji.
Thomas M. Fisher, Solicitor General of Indiana, argued
the cause for the State of Indiana et al. as amici curiae urg-
ing reversal. With him on the brief were Theodore E. Rok-
ita, Attorney General of Indiana, James A. Barta, Deputy
Solicitor General, and Julia C. Payne and Melinda R.
Holmes, Deputy Attorneys General, and by the Attorneys
General for their respective States as follows: Steve Mar-
shall of Alabama, Treg Taylor of Alaska, Leslie Rutledge of
Arkansas, Ashley Moody of Florida, Lawrence Wasden of
Idaho, Derek Schmidt of Kansas, Daniel Cameron of Ken-
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170 HEAL
TH AND HOSPITAL CORPORATION OF MARION
CTY. v. TALEVSKI
Counsel
tucky, Jeff Landry of Louisiana, Lynn Fitch of Mississippi,
Au
stin Knudsen of Montana, Doug Peterson of Nebraska,
John Formella of New Hampshire, David A. Yost of Ohio,
John M. O'Connor of Oklahoma, Alan Wilson of South Caro-
lina, Mark Vargo of South Dakota, Herbert H. Slatery III of
Tennessee, Ken Paxton of Texas, Sean Reyes of Utah, Jason
Miyares of Virginia, and Patrick Morrisey of West Virginia.
Benjamin W. Snyder argued the cause for the United
States as amicus curiae. With him on the brief were Solic-
itor General Prelogar, Principal Deputy Assistant Attorney
General Boynton, Deputy Solicitor General Kneedler, Mark
B. Stern, and Alisa B. Klein.
Andrew T. Tutt argued the cause for respondent. With
him on the briefs were R. Stanton Jones, Kristine Black-
wood, Stephen K. Wirth, and Susie Talevski.*
*Briefs of amici curiae urging reversal were fled for the American
Health Care Association et al. by James F. Segroves; and for the National
Conference of State Legislatures et al. by Christopher J. Wright, John R.
Grimm, and Lisa Soronen.
Briefs of amici curiae urging affrmance were fled for AARP et al.
by Maame Gyamf, William Alvarado Rivera, and Kelly Bagby; for the
American Cancer Society Cancer Action Network et al. by Thomas W.
Curvin, John H. Fleming, Thomas M. Byrne, and Mary Rouvelas; for the
American Public Health Association et al. by Stephanie A. Webster; for
the Constitutional Accountability Center et al. by Elizabeth B. Wydra,
Brianne J. Gorod, David D. Cole, and Kenneth J. Falk; for Contract Law
Professors et al. by Thomas G. Sprankling and Charles C. Bridge; for
Former Members of Congress by Matthew J. Dowd; for Former Senior
Offcials of the Department of Health and Human Services by Ishan K.
Bhabha, Samuel S. Ungar, and Stephen I. Vladeck; for the Georgia Advo-
cacy Offce et al. by Paul Koster; for Indiana Disability Rights by Emily
A. Munson; for the Indiana Trial Lawyers Association by Ashley N. Hadler;
for the Judge David L. Bazelon Center for Mental Health Law et al. by
Aaron M. Panner and Ira A. Burnim; for Members of Congress by Anjali
Srinivasan; for the National Health Law Program et al. by Donald B. Ver-
rilli, Jr., and Jane Perkins; for the Pennsylvania Association for Justice
et al. by Robert F. Daley, Jeffrey R. White, and Greg Heller; for Public Citi-
zen by Wendy Liu and Scott L. Nelson; for Statutory Interpretation Schol-
ars by Karla Gilbride; for Toby S. Edelman by Theodore A. Howard; and for
Daniel L. Hatcher by Robert J. Ward, Douglas I. Koff, and Frank Olander.

Cite
as: 599 U. S. 166 (2023)
171
Opinion of the Court
Justice Jackson delivered the opinion of the Court.
The
Federal Nursing Home Reform Act (FNHRA or Act)
ensures that nursing homes that receive Medicaid funding
respect and protect their residents' health, safety, and dig-
nity. Provisions of the FNHRA refer to rights of nursing-
home residents to be free from unnecessary physical or
chemical restraints and to be discharged or transferred only
when certain preconditions are satisfed. This case is about
these particular provisions and whether nursing-home resi-
dents can seek to vindicate those FNHRA rights in court.
Respondent Ivanka Talevski maintains that she can en-
force the rights these particular FNHRA provisions describe
via 42 U. S. C. § 1983, which, since the 1870s, has provided an
express cause of action to any person deprived (by someone
acting under color of state law) of “any rights . . . secured by
the Constitution and laws.” Petitioners insist that respond-
ent is wrong about being able to rely on § 1983 in this con-
text, for two independent reasons. First, petitioners urge
us to discard our longstanding recognition that § 1983's un-
qualifed reference to “laws” “means what it says,” Maine v.
Thiboutot, 448 U. S. 1, 4 (1980), and to rule instead that
§ 1983 contains an implicit carveout for laws that Congress
enacts via its spending power—a holding that, according to
petitioners, would mean that § 1983 could not be used to en-
force any rights the FNHRA purports to recognize. In the
alternative, petitioners point to our established methods for
determining whether a statutory provision creates a § 1983-
Briefs of amici curiae were fled for the California Medical Association
by Stacey M. Leyton; for Children's Health Care Providers and Advocates
by Benjamin G. Shatz; for Health Policy Scholars by Carolyn F. Corwin
and Virginia A. Williamson; for the Institute for Justice by Brian A.
Morris; for the National Association of Community Health Centers et al.
by Edward T. Waters, Matthew Sidney Freedus, Phillip A. Escoriaza,
and Rosie Dawn Griffn; for the National Center for Youth Law et al. by
Constance Van Kley, Rylee Sommers-Flanagan, Gregory Bass, and
Brenda Shum; for Retired Lawyers by William J. Rold, John W. Cleve-
land, and Arthur S. Leonard, all pro se; and for Robert M. Kerr by Chris-
topher P. Schandevel, John J. Bursch, Kelly M. Jolley, and Ariail B. Kirk.
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172 HEAL
TH AND HOSPITAL CORPORATION OF MARION
CTY. v. TALEVSKI
Opinion of the Court
enforceable right and maintain that these FNHRA provi-
si
ons do not create rights that nursing-home residents can
enforce via § 1983.
We reject both propositions. “Laws” means “laws,” no
less today than in the 1870s, and nothing in petitioners' ap-
peal to Reconstruction-era contract law shows otherwise.
Consequently, as we have previously held, § 1983 can pre-
sumptively be used to enforce unambiguously conferred fed-
eral individual rights, unless a private right of action under
§ 1983 would thwart any enforcement mechanism that the
rights-creating statute contains for protection of the rights
it has created. Fitzgerald v. Barnstable School Comm., 555
U. S. 246, 253–255 (2009); Gonzaga Univ. v. Doe, 536 U. S.
273, 284, and n. 4 (2002). We hold that the two FNHRA
provisions at issue here do unambiguously create § 1983-
enforceable rights. And we discern no incompatibility be-
tween private enforcement under § 1983 and the statutory
scheme that Congress has devised for the protection of those
rights. Accordingly, we affrm the lower court's judgment
that respondent's § 1983 action can proceed in court.
I
In 2016, when Gorgi Talevski's dementia progressed to the
point that his family members could no longer care for him,
they placed him in petitioner Valparaiso Care and Rehabili-
tation's (VCR) nursing home.
1
When he entered VCR,
Mr. Talevski could talk, feed himself, walk, socialize, and rec-
ognize his family. Later in 2016, however, Mr. Talevski's
condition suddenly deteriorated. He became unable to eat
on his own and began losing the ability to communicate in
English (leaving him to rely primarily on Macedonian, his
native language).
VCR staff claimed this was dementia's natural progres-
sion. But Mr. Talevski's daughter suspected, and then con-
1
We rely for these facts on the operative complaint's well-pleaded alle-
gations. See Walden v. Fiore, 571 U. S. 277, 281, n. 2 (2014).
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173
Opinion of the Court
frmed with outside physicians, that VCR was chemically
restrai
ning Mr. Talevski with six powerful psychotropic med-
ications. With the help of an outside neurologist, his medi-
cation was tapered down, and he began to regain the ability
to feed himself. Around this time, the Indiana State De-
partment of Health (Department) conducted its periodic in-
spection of VCR, and the Talevskis fled a formal complaint
with the inspectors regarding the chemical restraints.
The problems did not end there. Toward the end of 2016,
VCR began asserting that Mr. Talevski was harassing female
residents and staff. Based on that claim, VCR began send-
ing Mr. Talevski to a psychiatric hospital 90 minutes away
for several days at a time. VCR readmitted Mr. Talevski
the frst two times it sent him away. But the third time,
instead of accepting him back, VCR tried to force his perma-
nent transfer to a dementia facility in Indianapolis. It exe-
cuted these changed circumstances without frst notifying
Mr. Talevski or his family.
The Talevskis fled a complaint with the Department re-
garding Mr. Talevski's forced transfer. While the complaint
was pending, Mr. Talevski had to stay at another facility that
was 90 minutes away from his family. Eventually, a Depart-
ment administrative law judge nullifed VCR's attempted
transfer of Mr. Talevski. Based on that determination,
the Talevskis endeavored to have Mr. Talevski returned to
VCR. But VCR ignored the judge's decision and refused
readmission.
The Talevskis complained again to the Department, which
later issued a report regarding the Talevskis' complaints.
Subsequently, petitioner American Senior Communities LLC
(ASC), which manages VCR, contacted Mr. Talevski's wife,
Ivanka, to discuss the possibility of Mr. Talevski's return.
At this point, however, Mr. Talevski had acclimated to his
new home, and the Talevskis feared retribution against him
if he returned to VCR. So they opted to leave him in the
new facility, which meant that every family visit required a
3-hour round trip.
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174 HEAL
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Opinion of the Court
In 2019, Mr. Talevski (through Ivanka) sued VCR, ASC,
and
petitioner Health and Hospital Corporation of Marion
County (col lec tively, HHC) under Rev. St at. § 1979, 42
U. S. C. § 1983.
2
The lawsuit claimed that HHC's treatment
of Mr. Talevski—in particular, the use of chemical restraints
and the persistent transfer attempts—had violated rights
that the FNHRA guaranteed him as a nursing-home resi-
dent. The District Court granted HHC's subsequent mo-
tion to dismiss the complaint, reasoning that no plaintiff can
enforce provisions of the FNHRA via § 1983.
The Court of Appeals for the Seventh Circuit reversed.
It concluded that, under this Court's precedent, the relevant
FNHRA provisions “unambiguously confer individually en-
forceable rights on nursing-home residents,” making those
rights presumptively enforceable via § 1983. 6 F. 4th 713,
720 (2021). The Court of Appeals held further that the pre-
sumption had not been rebutted here, because nothing in the
FNHRA indicated congressional intent to foreclose § 1983
enforcement of these rights. Id., at 720–721.
HHC fled a petition for certiorari, which we granted.
3
596 U. S. ––– (2022). For the reasons explained below, we
affrm the Seventh Circuit's judgment.
II
A
As relevant here, § 1983 provides that
“[e]very person who, under color of any statute, ordi-
nance, regulation, custom, or usage, of any State or Ter-
2
Marion County, Indiana, owns Health and Hospital Corporation, which
in turn wholly owns VCR.
3
After the Seventh Circuit's ruling, Mr. Talevski passed away. We
granted Ivanka Talevski's substitution motion, and substituted her as a
party at the same time we granted certiorari. See Supreme Court Rule
35.1. Subsequent references to Talevski encompass both Talevskis inso-
far as Ivanka is advancing Gorgi's interests.
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Opinion of the Court
ritory or the District of Columbia, subjects, or causes to
be
subjected, any citizen of the United States or other
person within the jurisdiction thereof to the deprivation
of any rights, privileges, or immunities secured by the
Constitution and laws, shall be liable to the party in-
jured in an action at law, suit in equity, or other proper
proceeding for redress.”
That is, any person within the jurisdiction of the United
States may invoke this cause of action against any other per-
son who, acting “under color of ” state law, has deprived them
of “any rights, privileges, or immunities secured by the Con-
stitution and laws” of the United States.
We have been asked before to narrow the scope of this
express authorization, i. e., to read “laws” to mean only “civil
rights or equal protection laws.” Thiboutot, 448 U. S., at 6.
We declined to do so, reasoning that a straightforward read-
ing of the “plain language” of § 1983 is required. Id., at 4.
That should have been no surprise; “Congress attached no
modifers to the phrase [`and laws'].” Ibid.
Since Thiboutot, we have crafted a test for determining
whether a particular federal law actually secures rights
for § 1983 purposes. See Gonzaga, 536 U. S., at 283–285;
Part III–B, infra. But we have not previously doubted that
any federal law can do so.
B
1
HHC attempts to sow renewed doubt about § 1983's textu-
ally unqualifed sweep by proffering “historical evidence.”
Brief for Petitioners 3; see also id., at 2 (asserting that “[f]or
most of this nation's history, individuals did not have a recog-
nized private right to enforce obligations prescribed by fed-
eral statutes”). As background for our evaluation of the
particulars of HHC's Spending Clause-based argument re-
garding § 1983's meaning, see Part II–B–2, infra, a fuller pic-
ture of the relevant historical context is warranted. United
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Opinion of the Court
States v. Union Pacifc R. Co., 91 U. S. 72, 79 (1875); accord,
T
owne v. Eisner, 245 U. S. 418, 425 (1918) (Holmes, J., for
the Court).
Before the Civil War, few direct federal protections for
individual rights against state infringements existed. The
Thirteenth, Fourteenth, and Fifteenth Amendments worked
a sea change in this regard. See McDonald v. Chicago, 561
U. S. 742, 754 (2010); Fitzpatrick v. Bitzer, 427 U. S. 445, 453–
456 (1976); Ex parte Virginia, 100 U. S. 339, 344–345 (1880).
Still, neither these Civil War Amendments nor the landmark
Civil Rights Act of 1866 successfully prevented postbellum
state actors from continuing to deprive American citizens of
federally protected rights. Mitchum v. Foster, 407 U. S.
225, 240 (1972).
In early 1871, a Senate Select Committee produced and
distributed a Report that ran hundreds of pages and re-
counted pervasive state-sanctioned lawlessness and violence
against the freedmen and their White Republican allies.
Monroe v. Pape, 365 U. S. 167, 174 (1961) (citing S. Rep.
No. 1, 42d Cong., 1st. Sess. (1871)).
4
After reading the Re-
port, President Ulysses S. Grant implored Congress to act.
It is against this backdrop that the 42d Congress enacted,
and President Grant signed, the Civil Rights Act of 1871.
4
Encapsulating the Report, victim testimony, and press accounts for his
colleagues, one Congressman (as Monroe noted) lamented that “ `murder
is stalking abroad in disguise, . . . whippings and lynchings and banishment
have been visited upon unoffending American citizens, [and] the local ad-
ministrations have been found inadequate or unwilling to apply the proper
corrective.' ” 365 U. S., at 175 (quoting Cong. Globe, 42d Cong., 1st Sess.,
App. 374 (1871)). Another, summing up the same facts, stated:
“ `Sheriffs, having eyes to see, see not; judges, having ears to hear, hear
not; witnesses conceal the truth or falsify it; grand and petit juries act as
if they might be accomplices. . . . [A]ll the apparatus and machinery of civil
government, all the processes of justice, skulk away as if government and
justice were crimes and feared detection. Among the most dangerous
things an injured party can do is to appeal to justice.' ” Mitchum, 407
U. S., at 241 (quoting Cong. Globe, 42d Cong., 1st Sess., App. 78).
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177
Opinion of the Court
The frst section of that statute, as reenacted in 1874, created
the
federal cause of action now codifed as § 1983. Chapman
v. Houston Welfare Rights Organization, 441 U. S. 600, 608,
and n. 16 (1979) (citing Rev. Stat. § 1979 (1874)). The “plain
language['s]” lack of “modifers,” Thiboutot, 448 U. S., at 4,
refected the regrettable reality that “state instrumentali-
ties” could not, or would not, fully protect federal rights,
Mitchum, 407 U. S., at 242.
We have adhered to this understanding of § 1983's opera-
tion. To guarantee the protection of federal rights, “the
§ 1983 remedy . . . is, in all events, supplementary to any
remedy any State might have.” Owens v. Okure, 488 U. S.
235, 248 (1989) (internal quotation marks omitted); Knick v.
Township of Scott, 588 U. S. –––, ––– (2019). And we have
consistently refused to read § 1983's “plain language” to mean
anything other than what it says. Thiboutot, 448 U. S.,
at 4–6 (observing that our cases, running back to at least
1968, only make sense if “laws” indeed means “laws”).
2
We are not persuaded by HHC's argument (which Justice
Thomas supports, see post, at 196, 229 (dissenting opinion)),
that Talevski cannot invoke § 1983 to vindicate the rights the
FNHRA provisions at issue here purport to recognize be-
cause Congress seems to have enacted the FNHRA pursuant
to the spending power recognized in Article I, § 8, of the
Constitution.
5
HHC's argument generally proceeds as follows. Starting
with our precedent regarding Congress's spending power,
HHC begins by emphasizing our observation that federal
legislation premised on that power is “much in the nature of
a contract,” because, “in return for federal funds, the States
5
See Art. I, § 8, cl. 1 (authorizing the Legislature to “lay and collect
Taxes . . . to pay the Debts and provide for the common Defence and
general Welfare of the United States”).
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agree to comply with federally imposed conditions.” Penn-
hurst
State School and Hospital v. Halderman, 451 U. S. 1,
17 (1981); see also Cummings v. Premier Rehab Keller, 596
U. S. –––, ––– (2022). HHC then seizes on the “contract”
analogy to create a syllogism. It reasons that (1) any pri-
vate party suing to enforce an obligation between Federal
and State Governments that a Spending Clause statute cre-
ates is, essentially, a “third-party benefciary” (by which
HHC means benefciaries of rights created in any such
statute); and (2) under common-law contract principles ex-
tant at the time that Congress enacted § 1983, third-party
benefciaries were “generally” barred from suing to enforce
contract obligations; therefore, (3) plaintiffs like Talevski, as
a purported third-party benefciary of the FNHRA, may
not use § 1983 to do something that third-party benefciaries
of contracts generally could not do in the 1870s. Brief
for Petitioners 13, 17–18 (citing 1870s treatises and state
cases).
The upshot, for HHC, is that “Spending Clause statutes do
not give rise to privately enforceable rights under Section
1983” because contracts were not “generally” enforceable by
third-party benefciaries at common law. Id., at 11, 13. On
this basis alone, HHC thus, in effect, urges us to reject dec-
ades of precedent, and to rewrite § 1983's plain text to read
“laws (unless those laws rest on the Spending Power).”
Two well-established principles, applied here, suffce to re-
ject HHC's invitation to reimagine Congress's handiwork
(and our precedent interpreting it).
First, our prior § 1983 cases reference “ `frmly rooted' ”
common-law principles. Wyatt v. Cole, 504 U. S. 158, 164
(1992). We implement Congress's choices rather than re-
make them. Azar v. Allina Health Services, 587 U. S.
–––, ––– – ––– (2019). Thus, we have reasoned that Con-
gress's failure to displace frmly rooted common-law prin-
ciples genera l ly i ndicates that it i ncor porated those
established principles into § 1983. Wyatt, 504 U. S., at 163–
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164.
6
H
ere, HHC's key common-law plank—that third-
party benefciaries could not sue to enforce contractual
obligations during the relevant time—is, at a minimum, con-
testable. See Brief for Contract Law Professors et al. as
Amici Curiae 4 (“[A] majority of American jurisdictions . . .
permit[ted] third-party benefciaries to sue through at least
the early 1870s”); see also Hendrick v. Lindsay, 93 U. S. 143,
149 (1876) (concluding that “the right of a party to maintain
assumpsit on a promise not under seal, made to another for
his beneft, . . . is now the prevailing rule in this country”).
7
“[S]omething more than `ambiguous historical evidence' is
required before we will `fatly overrule a number of major
decisions of this Court,' ” Gamble v. United States, 587 U. S.
–––, ––– (2019), as HHC essentially asks us to do here.
Second, because “[t]here is no doubt that the cause of ac-
tion created by § 1983 is, and was always regarded as, a tort
claim,” Monterey v. Del Monte Dunes at Monterey, Ltd., 526
U. S. 687, 727 (1999) (Scalia, J., concurring in part and concur-
ring in judgment), HHC's particular focus on 1870s law gov-
erning third-party-benefciary suits in contract is, at the very
least, perplexing. If there is a reason that the principles
governing those suits should be read to displace the plain
6
For example, we have recognized immunities in the § 1983 context
when a “ `tradition of immunity was so frmly rooted in the common law
and was supported by such strong policy reasons that “Congress would
have specifcally so provided had it wished to abolish” ' ” that particular
immunity. Wyatt, 504 U. S., at 164 (quoting Owen v. Independence, 445
U. S. 622, 637 (1980)); see also Tenney v. Brandhove, 341 U. S. 367, 372–
376 (1951) (rooting immunity in a well-settled, pre-Revolutionary tradition
that Congress could not be thought to have “covert[ ly]” abrogated). We
relied on similar reasoning when consulting well-settled common-law prin-
ciples to determine the “contours of a [§ 1983] claim,” Nieves v. Bartlett,
587 U. S. –––, ––– (2019), the accrual date for § 1983 claims, McDonough v.
Smith, 588 U. S. –––, ––– (2019) (citing, inter alia, Heck v. Humphrey, 512
U. S. 477, 483 (1994)), and “ `prerequisites for th[e] recovery' ” of monetary
damages, id., at 483 (quoting Carey v. Piphus, 435 U. S. 247, 257–258 (1978)).
7
Black's Law Dictionary 154 (11th ed. 2019) (defning assumpsit, as rele-
vant, as a “common-law action for . . . breach of a contract”).

180 HEAL
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scope of § 1983's “ `species of tort liability,' ” Heck v. Hum-
phrey
, 512 U. S. 477, 483 (1994), HHC has utterly failed to
identify it.
We have no doubt that HHC wishes § 1983 said something
else. But that is “an appeal better directed to Congress.”
Nieves v. Bartlett, 587 U. S. –––, ––– (2019) (Gorsuch, J.,
concurring in part and dissenting in part). Hewing to
§ 1983's text and history (not to mention our precedent and
constitutional role), we reject HHC's request, and reaffrm
that “laws” in § 1983 means what it says. Thiboutot, 448
U. S., at 4.
8
III
The FNHRA can create § 1983-enforceable rights. But
do the two FNHRA provisions at issue in this case actually
do so? In that respect, our precedent sets a demanding bar:
Statutory provisions must unambiguously confer individual
federal rights. Gonzaga, 536 U. S., at 280. For the reasons
explained below, we conclude that the bar has been cleared
with respect to the presently contested provisions. And
while the FNHRA itself might nevertheless evince Con-
gress's intent to preclude the use of § 1983 to enforce these
particular rights, id., at 284, n. 4, we hold further that it
does not.
A
The FNHRA provisions at issue in this case, like the rest
of the Act, stem from a longstanding national commitment
8
HHC's reply brief retreats from its initial ask, by appearing to concede
that Spending Clause legislation can secure individual rights under § 1983,
but (it says) only if the statutory language “giv[es] funding recipients clear
notice.” Reply Brief 1. This newly minted argument contradicts the
opening brief 's categorical claims about the scope of § 1983. In any event,
the well-established requirement that Congress must have “unambigu-
ously conferred” a § 1983-enforceable right in a Spending Clause statute
ensures the clear notice that HHC's reply brief requests. Gonzaga Univ.
v. Doe, 536 U. S. 273, 279–280, 283 (2002); Part III, in fra.
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to provide safe and dignifed care for the elderly. Since as
ear
ly as the Social Security Act of 1935, federal law has
aimed in myriad ways to promote nursing homes that pro-
vide quality services. Yet, concerns about the poor condi-
tion of such facilities persisted even after Congress enacted
the 1965 Medicare and Medicaid Acts,
9
partly due to wide-
spread noncompliance with existing federal and state laws.
See Institute of Medicine, Improving the Quality of Care in
Nursing Homes 2–3, 11, 241–246 (1986); H. R. Rep. No. 100–
391, pt. 1, pp. 448–452 (1987). Thus, in 1987, Congress
passed, and President Ronald Reagan signed, the FNHRA,
effecting a “seismic shift” in nursing-home quality standards.
B. Furrow, T. Greaney, S. Johnson, T. Jost, & R. Schwartz,
Health Law 51 (3d ed. 2015) (Health Law).
10
The FNHRA
is largely composed of a litany of statutory requirements that
Congress laid out for Medicaid-participant States and “nurs-
ing facilities.” § 1396a(a)(28).
11
Those include “[r]equire-
ments relating to residents' rights,” § 1396r(c) (boldface
deleted), two of which Talevski's complaint invoked.
The frst requires nursing facilities to “protect and pro-
mote” residents' “right to be free from . . . any physical or
9
Medicare “provides Government-funded health insurance to” millions
of “elderly or disabled Americans,” while Medicaid “provides health insur-
ance to all low-income individuals, regardless of age or disability.” Be-
cerra v. Empire Health Foundation, for Valley Hospital Medical Center,
597 U. S. –––, ––– – ––– (2022).
10
The Omnibus Budget Reconciliation Act of 1987 added the FNHRA
to Title XIX of the Social Security Act, i. e., Medicaid. See 101 Stat.
1330–182. The FNHRA added a materially identical section to the
Medicare-focused portion of the Social Security Act, 101 Stat. 1330–160,
42 U. S. C. § 1395i–3 et seq. Because Talevski's complaint relies only on
the Medicaid-related FNHRA provisions, App. to Pet. for Cert. 76a, we
hereafter follow the parties and the Court of Appeals in referring only to
the pertinent Medicaid provisions, as codifed in the U. S. Code (§§ 1396a
(a)(28), 1396r).
11
“Nursi ng faci lity” is the FNHRA's ter m for a nursi ng home.
§ 1396r(a).
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chemical restraints imposed for purposes of discipline or
con
venience and not required to treat the resident's medical
symptoms.” § 1396r(c)(1)(A)(ii) (referred to herein as “the
unnecessary-restraint provision”). The second appears in a
subparagraph concerning “[t]ransfer and discharge rights,”
§ 1396r(c)(2)(A) (boldface deleted), and tells nursing facilities
that they “must not transfer or discharge [a] resident” unless
certain enumerated preconditions, including advance notice
of such a transfer or discharge, are met. E. g., §§ 1396r(c)
(2)(A)–(B) (referred to herein as “the predischarge-notice
provision”).
As for enforcement, like other aspects of Medicaid, the
FNHRA anticipates “cooperative federalism”—i. e., federal
and state actors working together—to carry out the statute's
aims. Wisconsin Dept. of Health and Family Servs. v.
Blumer, 534 U. S. 473, 495 (2002). Thus, qualifying State
Medicaid plans, which are approved by the Secretary of the
U. S. Department of Health and Human Services (HHS Sec-
retary), § 1396a(b), must include provisions that relate to
nursing facilities, and must require “any nursing facility re-
ceiving payments under” the plan to satisfy certain FNHRA
mandates. § 1396a(a)(28). The HHS Secretary must also
“assure that” approved state plans—and “the enforcement of
[plan] requirements”—are, inter alia, “adequate” to “protect
the health, safety, welfare, and rights of [nursing-home] resi-
dents.” § 1396r(f )(1).
The FNHRA also establishes a detailed administrative
scheme for government inspections of nursing facilities.
§ 1396r(g). “Surveys” (in the statute's parlance) must be
conducted to detect nursing homes that are falling short of
the FNHRA's minimum standards, and state and federal of-
fcials must periodically fle certifcations, based on these
surveys, regarding nursing-home compliance, see § 1396r(g)
(1)(A). In addition, the statute authorizes government
actors to sanction and correct noncompliant facilities, or, if
appropriate, exclude them from the Medicaid program en-
tirely. § 1396r(h); see also Health Law 56–63.
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Although
federal
Opinion of the Court
B
1
statutes have the potential to create
§ 1983-enforceable rights, they do not do so as a matter of
course. For Spending Clause legislation in particular, we
have recognized that “ `the typical remedy for state noncom-
pliance with federally imposed conditions is not a private
cause of action for noncompliance but rather action by the
Federal Government to terminate funds to the State.' ”
Gonzaga, 536 U. S., at 280 (quoting Pennhurst, 451 U. S., at
28). The parties here thus dispute whether this is the atypi-
cal case; that is, whether the unnecessary-restraint and
predischarge-notice provisions of the FNHRA “unambigu-
ously confe[r]” individual rights, making those rights “pre-
sumptively enforceable” under § 1983. 536 U. S., at 283–284.
Gonzaga sets forth our established method for ascertain-
ing unambiguous conferral. Courts must employ traditional
tools of statutory construction to assess whether Congress
has “unambiguously conferred” “individual rights upon a
class of benefciaries” to which the plaintiff belongs. Id., at
283, 285–286; see also Rancho Palos Verdes v. Abrams, 544
U. S. 113, 120 (2005). Notably, it must be determined that
“Congress intended to create a federal right” for the identi-
fed class, not merely that the plaintiffs fall “within the gen-
eral zone of interest that the statute is intended to protect.”
Gonzaga, 536 U. S., at 283 (emphasis deleted). This para-
digm respects Congress's primacy in this arena and thus vin-
dicates the separation of powers. Id., at 286.
We have held that the Gonzaga test is satisfed where the
provision in question is “ `phrased in terms of the persons
benefted' ” and contains “rights-creating,” individual-centric
language with an “ `unmistakable focus on the benefted
class.' ” Id., at 284, 287 (emphasis deleted). Conversely, we
have rejected § 1983 enforceability where the statutory pro-
vision “contain[ed] no rights-creating language”; had “an
aggregate, not individual, focus”; and “serve[d] primarily to
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direct the [Federal Government's] distribution of public
funds.
” Id., at 290.
If a statutory provision surmounts this signifcant hurdle,
it “secure[s] ” § 1983-enforceable r ights, consistent with
§ 1983's text. And because “§ 1983 generally supplies a rem-
edy for the vindication of rights secured by federal statutes,”
rights so secured are deemed “presumptively enforceable”
under § 1983. Id., at 284.
2
The unnecessary-restraint and predischarge-notice provi-
sions meet this test. To start, we note that both reside in 42
U. S. C. § 1396r(c), which expressly concerns “[r]equirements
relating to residents' rights.” Ibid. (emphasis added; bold-
face deleted); see also West Virginia v. EPA, 597 U. S.
–––, ––– (2022) (statutory provisions “ `must be read in their
context and with a view to their place in the overall statu-
tory scheme' ”). This framing is indicative of an individual
“rights-creating ” focus. Gonzaga, 536 U. S., at 284. Exam-
ined further, the text of the unnecessary-restraint and
predischarge-notice provisions unambiguously confers rights
upon the residents of nursing-home facilities.
The unnecessary-restraint provision requires nursing
homes to “protect and promote . . . [t]he right to be free
from . . . any physical or chemical restraints imposed for
purposes of discipline or convenience and not required to
treat the resident's medical symptoms.” § 1396r(c)(1)(A)(ii)
(emphasis added). The provision's enumerated exceptions
further sustain the focus on individual residents. For exam-
ple, nursing homes may use restraints “to ensure the physi-
cal safety of the resident or other residents,” but “only upon
the written order of a physician that specifes the duration
and circumstances under which the restraints are to be used”
(absent emergency circumstances specifed by the HHS Sec-
retary). §§ 1396r(c)(1)(A)(ii)(I)–(II) (emphasis added).
The predischarge-notice provision is more of the same.
Nestled in a paragraph concerning “transfer and discharge
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rights,” § 1396r(c)(2) (emphasis added; boldface deleted), that
prov
ision tells nursing facilities that they “must not transfer
or discharge [a] resident” unless certain preconditions are
met, including advance notice of the transfer or discharge
to the resident and his or her family. §§ 1396r(c)(2)(A)–(B)
(emphasis added). And, again, the statute's caveats remain
focused on individual residents: A nursing home may trans-
fer or discharge such an individual if, among other things,
the transfer is “necessary to meet the resident's welfare”; or
if the resident's health has improved so much that the facility
is no longer necessary; or if the safety or health of other
individuals would be endangered. § 1396r(c)(2)(A) (emphasis
added). The exceptions to the advance-notice requirement,
too, turn (inter alia) on the “resident's health,” the “resi-
dent's urgent medical needs,” or the existence of threats to
the safety or health of other individuals in the nursing home.
§§ 1396r(c)(2)(B)(ii)(I)–(III) (emphasis added).
To be sure, these two provisions also establish who it is
that must respect and honor these statutory rights; namely,
the Medicaid-participant nursing homes in which these resi-
dents reside. See, e. g., §§ 1396a(a)(28), 1396r(c)(1)(A),
1396r(c)(2)(A); see also §§ 1396r(c)(1)(B)(i)–(ii) (requiring nur-
sing homes to inform nursing-home residents of their rights,
orally and in writing, upon admission and upon request).
But that is not a material diversion from the necessary focus
on the nursing-home residents, contrary to HHC's represen-
tations. Indeed, it would be strange to hold that a statutory
provision fails to secure rights simply because it considers,
alongside the rights bearers, the actors that might threaten
those rights (and we have never so held).
12
The unnecessary-restraint and predischarge-notice provi-
sions thus stand in stark contrast to the statutory provisions
that failed Gonzaga's test in Gonzaga itself. Those provi-
sions lacked “rights-creating language,” primarily directed
12
The Fourteenth Amendment hardly fails to secure § 1983-enforceable
rights because it directs state actors not to deny equal protection.
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the Federal Government's “distribution of public funds,” and
had
“an aggregate, not individual, focus.” 536 U. S., at 290.
The opposite is true here. The unnecessary-restraint and
predischarge-notice provisions use clear “rights-creating lan-
guage,” speak “ `in terms of the persons benefted,' ” and
have an “ `unmistakable focus on the benefted class.' ” Id.,
at 284, 287, 290 (emphasis deleted). Thus, they satisfy Gon-
zaga's stringent standard, and the rights they recognize are
presumptively enforceable under § 1983.
C
Even if a statutory provision unambiguously secures
rights, a defendant “may defeat th[e] presumption by demon-
strating that Congress did not intend” that § 1983 be avail-
able to enforce those rights. Rancho Palos Verdes, 544
U. S., at 120.
13
For evidence of such intent, we have looked
to “the statute creating the right.” Ibid. A statute could,
of course, expressly forbid § 1983's use. Fitzgerald, 555
U. S., at 252; Rancho Palos Verdes, 544 U. S., at 120. Ab-
sent such a sign, a defendant must show that Congress is-
sued the same command implicitly, by creating “a `compre-
hensive enforcement scheme that is incompatible with
individual enforcement under § 1983.' ” Id., at 120. Only
the latter path is at issue here.
13
The “ `rebuttable presumption' ” that our cases describe, Rancho Palos
Verdes, 544 U. S., at 120, is not an artifcially onerous court-made hur-
dle. It merely refects what § 1983's plain text commands: The § 1983
remedy is available to vindicate federal individual rights “secured by . . .
la[w].” In other words, the presumption recognizes that, even where
Congress has unambiguously secured certain federal individual rights by
law, it may have simultaneously given good reason (detectable with
ordinary interpretive tools) to conclude that the § 1983 remedy is not avail-
able for those rights, even though it “generally” is. Gonzaga, 536 U. S.,
at 284, and n. 4. And it also recognizes that it is the defendant's burden
to show that a right otherwise secured by law is not § 1983 enforce-
able. Rancho Palos Verdes, 544 U. S., at 120; Gonzaga, 536 U. S., at 284,
and n. 4.
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1
Our
precedent outlines what HHC must show to traverse
the implicit-preclusion path. “ `The crucial consideration' ”
is whether “Congress intended a statute's remedial scheme
to `be the exclusive avenue through which a plaintiff may
assert [his] claims.' ” Fitzgerald, 555 U. S., at 252 (quoting
Smith v. Robinson, 468 U. S. 992, 1009, 1012 (1984) (emphasis
added)); Fitzgerald, 555 U. S., at 252 (framing “ `[t]he critical
question' ” as “ `whether Congress meant [the statute's reme-
dial scheme] to coexist with . . . a § 1983 action' ” (quoting
Rancho Palos Verdes, 544 U. S., at 120–121)).
Our precedents make clear that the sine qua non of a fnd-
ing that Congress implicitly intended to preclude a private
right of action under § 1983 is incompatibility between en-
forcement under § 1983 and the enforcement scheme that
Congress has enacted. 555 U. S., at 252–254. We have
used many terms and concepts to describe the necessary dis-
cordance between § 1983 and a rights-conferring statute's
remedial scheme: “ `incompatible,' ” “ `inconsistent,' ” and
“thwar[t]” are examples. Id., at 252–255. In all events, the
question is whether the design of the enforcement scheme in
the rights-conferring statute is inconsistent with enforce-
ment under § 1983, such that a court must infer that “Con-
gress did not intend” to make available the “[§ 1983] remedy
for [these] newly created right[s].” Rancho Palos Verdes,
544 U. S., at 120; see also Fitzgerald, 555 U. S., at 252.
Put another way, the inquiry boils down to what Congress
intended, as divined from text and context. The application
of the traditional tools of statutory construction to a statute's
remedial scheme may reveal no incompatibility between the
enforcement scheme that Congress crafted in the rights-
conferring statute and enforcement under § 1983, or it may
uncover suffcient incompatibility to make manifest Con-
gress's intent to preclude § 1983 actions. See, e. g., id., at
253 (explaining a past implicit-preclusion case on the ground
that permitting § 1983 claims there would have “thwarted
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Congress' intent”); Rancho Palos Verdes, 544 U. S., at 127
(§
1983's operation would have “distort[ed]” the pertinent
other statute's remedial scheme).
2
We discern no incompatibility between the FNHRA's re-
medial scheme and § 1983 enforcement of the rights that the
unnecessary-restraint and predischarge-notice provisions un-
ambiguously secure.
As explained in Part III–A, supra, the FNHRA details
administrative processes concerning inspection of covered
nursing facilities and accountability for noncompliant facili-
ties. But the statute lacks any indicia of congressional in-
tent to preclude § 1983 enforcement, such as an express pri-
vate judicial right of action or any other provision that might
signify that intent. See, e. g., id., at 121 (“[T]he existence of
a more restrictive private remedy [in the statute itself] for
statutory violations has been the dividing line between those
cases in which we have held that an action would lie under
§ 1983 and those in which we have held that it would not”).
Nor has HHC otherwise demonstrated that enforcement via
§ 1983 would thwart the operation of the administrative re-
medial scheme in any respect.
HHC's argument that we need look no further than the
detail of the FNHRA's enforcement mechanisms to fnd con-
clusive evidence of implicit preclusion is unpersuasive. Im-
plicit preclusion is shown by a “ `comprehensive enforcement
scheme that is incompatible with individual enforcement
under § 1983.' ” Fitzgerald, 555 U. S., at 252 (emphasis
added). HHC's single-minded focus on comprehensiveness
mistakes the shadow for the substance, and it disregards the
import of these FNHRA provisions' unambiguous conferral
of rights. The attendant presumption is that § 1983 can play
its textually prescribed role as a vehicle for enforcing those
rights, even alongside a detailed enforcement regime that
also protects those interests, so long as § 1983 enforcement
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is not “ `incompatible' ” with Congress's handiwork. Rancho
P
alos Verdes, 544 U. S., at 120, 122; Blessing v. Freestone,
520 U. S. 329, 347–348 (1997) (collecting cases).
To be clear, a defendant can discharge its burden of show-
ing that the presumption is rebutted by pointing to a com-
prehensive scheme. Middlesex County Sewerage Authority
v. National Sea Clammers Assn., 453 U. S. 1, 20 (1981) (stat-
utory “remedial devices” that are “suffciently comprehen-
sive . . . may suffce” to show implicit preclusion). But when
a particular comprehensive remedial scheme discharges the
defendant's burden, it does so because the application of ordi-
nary interpretive tools reveals incompatibility, i. e., it demon-
strates that “Congress intended [that] statute's remedial
scheme to `be the exclusive avenue through which a plaintiff
may assert [his] claims.' ” Fitzgerald, 555 U. S., at 252.
Nothing in the FNHRA indicates the incompatibility
evinced in our three prior cases fnding implicit preclusion.
Rancho Palos Verdes, 544 U. S., at 120–123, 127; Smith, 468
U. S., at 1008–1013; Sea Clammers, 453 U. S., at 6–7, 19–21.
Rancho Palos Verdes, Smith, and Sea Clammers concerned
statutes with self-contained enforcement schemes that in-
cluded statute-specific rights of acti on. Rancho Pal os
Verdes, 544 U. S., at 120–123; Smith, 468 U. S., at 1008–1012;
Sea Clammers, 453 U. S., at 6–7, 17, and n. 27, 19–21. Each
such statute required plaintiffs to “comply with particular
procedures and/or to exhaust particular administrative rem-
edies” under the statute's enforcement scheme before suing
under its dedicated right of action. Fitzgerald, 555 U. S., at
254. And each statute-specifc right of action offered fewer
benefts than those available under § 1983. Ibid., and n. 1.
Thus, in all three cases, § 1983's operation would have
thwarted Congress's scheme coming and going: It would
have “circumvented” the statutes' presuit procedures, and
would have also “given plaintiffs access to tangible bene-
fts” as remedies that were “unavailable under the stat-
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scheme[s]' ” were “ `incompatible with individual enforcement
under
§ 1983.' ” Id., at 252 (quoting Rancho Palos Verdes,
544 U. S., at 120).
HHC has identifed no equivalent sign in the FNHRA; nor
has Justice Alito, see post, at 230, 232–235 (dissenting
opinion). In focusing on what the FNHRA contains, they
ignore what it lacks—a private judicial right of action, a pri-
vate federal administrative remedy, or any “ `carefu[l]' ” con-
gressional “ `tailor[ing],' ” Fitzgerald, 555 U. S., at 255, that
§ 1983 actions would “distort,” Rancho Palos Verdes, 544
U. S., at 127. HHC seems to think it enough to show that
Congress was not slipshod in crafting the remedial scheme.
But in a world where the FNHRA's remedial scheme could
“complement,” not “supplant, § 1983,” id., at 122, HHC must
demonstrate more than that.
One last rebuttal argument warrants addressing. The
United States says that, because private entities owned most
nursing homes when the FNHRA was enacted in 1987
(as they do now), the FNHRA is a rare bird for implicit-
preclusion purposes. In the United States' view, because
Congress knew that most nursing homes could not be subject
to suit under § 1983 anyway, see, e. g., Polk County v. Dod-
son, 454 U. S. 312, 317–319 (1981), the FNHRA's remedial
scheme “necessarily refects Congress's judgment that these
administrative enforcement mechanisms appropriately pro-
tect the rights the statute confers,” Brief for United States
as Amicus Curiae 31.
This argument is unavailing. The implicit-preclusion in-
quiry looks to “the statute creating the right” and any “ `com-
prehensive enforcement scheme' ” Congress has created in
the statute “ `that is incompatible with individual enforce-
ment under § 1983.' ” Rancho Palos Verdes, 544 U. S., at 120
(emphasis added). It does not invite speculation about os-
tensible marketplace realities that appear nowhere in the
statute's text or relevant context. The relevant FNHRA
provisions speak in neutral terms that do not distinguish be-
tween private and public nursing homes. And, regardless,

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191
Opinion of the Court
the question remains whether something in the FNHRA has
foreclosed
§ 1983's “genera[l]” availability as “a remedy for
the vindication of rights secured by federal statutes.” Gon-
zaga, 536 U. S., at 284. We see no such sign, much less a
license for us to construct and impute congressional intent
that the FNHRA does not embody.
The diffculty for HHC and the United States is that im-
plicit preclusion, in this context, requires something in the
statute that shows that permitting § 1983 to operate would
“thwar[t] Congress' intent” in crafting the FNHRA. Fitz-
gerald, 555 U. S., at 253. We see nothing in the FNHRA
that even hints at Congress's intent in this regard; if any-
thing, the language of the Act confrms otherwise, for it
plainly states that “[t]he remedies provided under” its
enforcement-process subsection are “in addition to those
otherwise available under State or Federal law and shall not
be construed as limiting such other remedies.” § 1396r(h)(8)
(emphasis added).
14
We will not rewrite § 1396r(h)(8) in lieu
of rewriting § 1983.
15
14
We found similar (but not identical) language to be insuffcient to pre-
serve the presumption in Middlesex County Sewerage Authority v. Na-
tional Sea Clammers Assn., 453 U. S. 1 (1981), and Rancho Palos Verdes
v. Abrams, 544 U. S. 113 (2005). See id., at 125–127. But those clauses
did not purport to preserve “other remedies,” and were embedded in stat-
utes that (unlike the FNHRA) contained private judicial rights of action.
See ibid.; Sea Clammers, 453 U. S., at 6–7, 20, and n. 31. The FNHRA's
explicitly expressed objective of preserving other remedies bolsters our
reluctance to infer implicit displacement of the § 1983 remedy. We think
Justice Alito's response in this regard overreads Rancho Palos Verdes.
See post, at 234–235. That case merely provided an unremarkable de-
scription of Sea Clammers' “refus[al] to read” the saving clauses there as
preserving § 1983 actions, in light of the different (and signifcant) textual
and contextual evidence of preclusion that the statutes at issue provided.
Rancho Palos Verdes, 544 U. S., at 127.
15
The United States' suggestion that § 1396r(h)(8) just ensures that rem-
edies available under non-FNHRA, non-§ 1983 statutes remain available
is not persuasive. Brief for United States as Amicus Curiae 34. Noth-
ing in the Act supports interpreting § 1396r(h)(8)'s language in that man-
ner, especially given § 1983's unqualifed command.
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TH AND HOSPITAL CORPORATION OF MARION
CTY. v. TALEVSKI
Gorsuch, J., concurring
***
A
t oral argument, HHC's counsel remarked that the “right
question” is “what rights are secured by law within the
meaning of [§] 1983.” Tr. of Oral Arg. 39. That is an accu-
rate statement of the key issue in this case. Section 1983
itself provides the answer. By its terms, § 1983 is avail-
able to enforce every right that Congress validly and un-
ambiguously creates; we will not impose a categorical font-
of-power condition that the Reconstruction Congress did
not. And, here, the test that our precedents establish leads
inexorably to the conclusion that the FNHRA secures the
particular rights that Talevski invokes, without other-
wise signaling that enforcement of those rights via § 1983
is precluded as incompatible with the FNHRA's remedial
scheme.
Accordingly, we affrm the judgment of the Court of
Appeals.
It is so ordered.
Justice Gorsuch, concurring.
Section 1983 permits individuals to sue to vindicate their
“rights . . . secured by . . . la[w].” Rev. Stat. § 1979, 42
U. S. C. § 1983. I agree with the Court's disposition of the
two questions we took this case to decide and in arriving
there largely track Justice Barrett's reasoning. First,
the Federal Nursing Home Reform Act qualifes as a “law”
for purposes of § 1983. Post, at 193 (Barrett, J., concur-
ring). Second, the text of the Act's operative provisions re-
fers to individual “rights.” Post, at 193–195 (same). But,
to my mind, there are other issues lurking here that petition-
ers failed to develop fully—whether legal rights provided for
in spending power legislation like the Act are “secured” as
against States in particular and whether they may be so se-
cured consistent with the Constitution's anti-commandeering
principle. See, e. g., National Federation of Independent
Business v. Sebelius, 567 U. S. 519, 575–578 (2012); Murphy
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193
Barrett, J., concurring
v. National Collegiate Athletic Assn., 584 U. S. –––, ––– –
–––
(2018). As I see it, those are questions for another day.
Justice Barrett, with whom The Chief Justice joins,
concurring.
Today's opinion makes three important points. First,
Maine v. Thiboutot remains good law. 448 U. S. 1 (1980).
Second, Gonzaga University v. Doe sets the standard for
determining when a Spending Clause statute confers individ-
ual rights, and the Federal Nursing Home Reform Act
(FNHRA) satisfes it. 536 U. S. 273 (2002). Third, courts
must carefully consider whether individual rights estab-
lished by a Spending Clause statute are enforceable through
42 U. S. C. § 1983—in the FNHRA's case, they are. As to
the frst point: Section 1983 provides a cause of action
against “[e]very person” who, under color of state law, vio-
lates “any rights, privileges, or immunities secured by the
Constitution and laws.” In Thiboutot, we held that the
plain language of the statute was not limited to “some subset
of laws.” 448 U. S., at 4. Rather, the term “laws” encom-
passes all federal laws, including those passed pursuant
to Congress's Spending Clause authority. Ibid. Like the
Court, I would not abandon that holding based on petition-
ers' novel contract-law theory.
Second, our decision in Gonzaga establishes the standard
for analyzing whether Spending Clause statutes give rise to
individual rights. Under Gonzaga, courts must ask whether
“text and structure” indicate that the statute “unambigu-
ously” confers federal rights. 536 U. S., at 283, 286. Rele-
vant considerations include whether the statute is “ `phrased
in terms of the persons benefted,' ” whether it uses “explicit
rights-creating terms,” and whether it has an “individual,”
rather than an “aggregate,” focus. Id., at 284, 290.
This bar is high, and although the FNHRA clears it, many
federal statutes will not. As the Court explains, § 1983 ac-
tions are the exception—not the rule—for violations of
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194 HEAL
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Barrett, J., concurring
Spending Clause statutes. Ante, at 183. This is because
“
the typical remedy for state noncompliance with federally
imposed conditions is not a private cause of action for non-
compliance but rather action by the Federal Government to
terminate funds to the State.” Pennhurst State School and
Hospital v. Halderman, 451 U. S. 1, 28 (1981). Indeed, since
Pennhurst, we have interpreted only two Spending Clause
statutes to be enforceable through § 1983. See Wright v.
Roanoke Redevelopment and Housing Authority, 479 U. S.
418, 432 (1987); Wilder v. Virginia Hospital Assn., 496 U. S.
498, 522–523 (1990).
The third point is that even when a statute unambiguously
confers rights, Congress can “supplant any remedy that
otherwise would be available under § 1983.” Middlesex
County Sewerage Authority v. National Sea Clammers
Assn., 453 U. S. 1, 21 (1981). At this step of the analysis,
courts should apply ordinary interpretive tools to determine
whether the statute allows access to § 1983. Ante, at 187;
see Sea Clammers, 453 U. S., at 13, 20–21 (“We look frst, of
course, to the statutory language, particularly to the provi-
sions made therein for enforcement and relief ”). In some
cases, the text may expressly forbid § 1983 actions. In oth-
ers, context may point to the same result. It is especially
telling, for example, if the statute “ `creat[es] a comprehen-
sive enforcement scheme that is incompatible with individual
enforcement under § 1983.' ” Gonzaga, 536 U. S., at 284–
285, n. 4.
As the Court notes, the presence of an “express private
judicial right of action” typically demonstrates that a § 1983
suit is not also available. Ante, at 188; see Rancho Palos
Verdes v. Abrams, 544 U. S. 113, 121 (2005) (express cause of
action “is ordinarily an indication that Congress did not in-
tend to leave open a more expansive remedy under § 1983”).
When the statutory cause of action restricts available reme-
dies or imposes procedural hurdles to obtaining relief, the
inference is even stronger. See Fitzgerald v. Barnstable

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195
Barrett, J., concurring
School Comm., 555 U. S. 246, 254 (2009) (considering whether
a
§ 1983 suit “would have circumvented these procedures
and given plaintiffs access to tangible benefts—such as dam-
ages, attorney's fees, and costs—that were unavailable under
the statut[e]”); Rancho Palos Verdes, 544 U. S., at 122–123
(similar).
But an actual clash—one private judicial remedy against
another, more expansive remedy—is not required to fnd that
a statute forecloses recourse to § 1983. Our cases have
looked to a wide range of contextual clues, like “enforcement
provisions” that “confe[r] authority to sue . . . on government
offcials,” Sea Clammers, 453 U. S., at 13, 20, and any “ad-
ministrative remedies” that the statute offers, Smith v. Rob-
inson, 468 U. S. 992, 1012 (1984). We have noted the rele-
vance of a centralized review mechanism that would be
undermined by piecemeal litigation. Gonzaga, 536 U. S.,
at 289–290 (statute directed the Secretary of Education to
establish a review board to investigate and adjudicate al-
leged violations). And we have regularly taken account of
the overall comprehensiveness of the statute's enforcement
scheme. The more comprehensive the scheme, the less
likely that it leaves the door open for § 1983 suits. Sea
Clammers, 453 U. S., at 20 (“When the remedial devices pro-
vided in a particular Act are suffciently comprehensive, they
may suffce to demonstrate congressional intent to preclude
the remedy of suits under § 1983”); Smith, 468 U. S., at 1011–
1012 (§ 1983 suits unavailable “[i]n light of the comprehensive
nature of the procedures and guarantees set out” in the stat-
ute). None of these features is necessarily determinative,
but each is part of the larger picture that courts must
assess.
Courts must tread carefully before concluding that Spend-
ing Clause statutes may be enforced through § 1983. In this
case, however, the Seventh Circuit correctly allowed Talev-
ski's § 1983 suit to proceed. I therefore join the Court's
opinion in full.
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Thomas, J., dissenting
Justice Thomas, dissenting.
I
agree with Justice Alito that the Federal Nursing
Home Reform Act (FNHRA) cannot be enforced through
Rev. Stat. § 1979, 42 U. S. C. § 1983, under Gonzaga Univ. v.
Doe, 536 U. S. 273 (2002). I write separately to highlight
another and more fundamental reason why FNHRA cannot
be enforced under § 1983. Section 1983 provides a cause of
action to redress only “the deprivation of any rights, privi-
leges, or immunities secured by the Constitution and laws.”
But legislation enacted pursuant to Congress' spending
power, like FNHRA, does not “secure” rights by “law.”
For nearly all of our Nation's history, it was understood
that there is a fundamental difference between the exercise
of Congress' sovereign legislative powers, on the one hand,
and the exercise of its power to spend money and to attach
conditions to the receipt of that money, on the other. Only
the former sort of legislation, which imposes obligations on
regulated parties with the force of law, directly secures by
law the rights corresponding to those obligations. By con-
trast, an exercise of Congress' spending power, whether it
comes from the so-called Spending Clause or elsewhere in
the Constitution, is no more than a disposition of funds. As
such, a conditional exercise of the spending power is nothing
more than a contractual offer; any “rights” that may fow
from that offer are “secured” only by the offeree's acceptance
and implementation, not federal law itself.
Since Maine v. Thiboutot, 448 U. S. 1 (1980), however, this
Court has ignored that fundamental distinction, permitting
third parties who beneft from spending conditions to enforce
them in § 1983 suits against state actors. In doing so, it has
created a constitutional quandary: If spending conditions
that beneft third parties are laws and secure rights in the
same manner as ordinary lawmaking under Congress' sover-
eign legislative powers, then such conditions would con-
tradict the bedrock constitutional prohibition against federal
commandeering of the States. We escape this quandary
only by recognizing spending conditions, not as rights-
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197
Thomas, J., dissenting
securing laws, but as the terms of possible contracts that
secure
rights only by virtue of an offeree's acceptance—the
very conclusion compelled by the traditional understanding
of the spending power. The choice between these alterna-
tives is stark and unavoidable: Either spending conditions in
statutes like FNHRA are not laws that secure rights cogni-
zable under § 1983, or they are unconstitutional direct regu-
lations of States. The Court must, at some point, revisit its
understanding of the spending power and its relation to
§ 1983.
I
This case arises from a § 1983 suit to enforce FNHRA's
spending conditions against a county-owned nursing home
that receives federal funding. Enacted under Congress'
spending power, FNHRA conditions the receipt of federal
Medicaid funding by States and nursing facilities on compli-
ance with a broad range of requirements.
These conditions largely consist of requirements that fund-
ing recipients protect certain “rights” of nursing-home resi-
dents. In a subsection entitled “[r]equirements relating to
residents' rights,” the Act requires recipients to “protect and
promote the rights of each resident,” including “[t]he right
to choose a personal attending physician” and make informed
medical decisions; “[t]he right to be free from physical or
mental abuse, corporal punishment, involuntary seclusion,
and any [medically unnecessary] physical or chemical re-
straints”; and “[t]he right[s] to privacy” and “confdentiality.”
42 U. S. C. §§ 1396r(c)(1)(A)(i)–(iv). The Act further pro-
vides that funding recipients “must permit each resident to
remain in the facility and must not transfer or discharge the
resident” without cause. § 1396r(c)(2)(A). Recipients must
also adopt procedures for residents to assert these “rights”
and to otherwise “voice grievances with respect to [their]
treatment or care.” § 1396r(c)(1)(A)(vi).
The Act also imposes many requirements directly and
uniquely upon participating States, including in a subsection
entitled “State requirements relating to nursing facility re-
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Thomas, J., dissenting
quirements. ” § 1396r(e). For instance, States must es-
t
ablish procedures for residents to challenge transfer and
discharge decisions and an appeals process for other determi-
nations. §§ 1396r(e)(3) and (e)(7)(F). States are also re-
quired to certify non-state-run facilities' compliance with the
Act's provisions by conducting annual surveys using proto-
cols developed by the Secretary of Health and Human Serv-
ices. § 1396r(g)(2)(A). If a State fnds that a facility is not
providing adequate care, it must conduct an extended survey.
§ 1396r(g)(2)(B). The Act also requires States to investigate
resident complaints and perform onsite monitoring at pre-
viously noncompliant or potentially noncompliant facilities.
§ 1396r(g)(4)(B). And, if it fnds a violation that “jeopar-
dize[s] the health or safety of [a facility's] residents, the State
shall take immediate action to remove the jeopardy and cor-
rect the defciencies.” § 1396r(h)(1)(A).
1
FNHRA's scheme is illustrative of many modern federal
spending programs, which often impose obligations directly
on States as a condition of funding. For example, as a condi-
tion on highway funding, the Clean Air Act requires States
to draft “State implementation plans” if their metropolitan
areas fail to satisfy national ambient air quality standards.
42 U. S. C. §§ 7410 and 7509(a)–(b). Among other require-
ments, these plans must include emission limitations, com-
pliance timetables, source monitoring, permitting systems,
enforcement programs, and publ ic par ticipati on. See
§ 7410(a)(2). Other examples, spanning virtually every do-
main of national and state policy, abound.
1
This survey merely scratches the surface of the requirements that
FNHRA imposes upon participating States. See also, e. g., 42 U. S. C.
§ 1396r(e)(4) (“[T]he State must have implemented and enforced the nurs-
ing facility administrator standards developed” by the Secretary for
Health and Human Services); § 1396r(e)(7)(B)(i)(I) (in the case of mentally
ill residents, “the State . . . must review and determine . . . whether or
not the resident . . . requires the level of services provided by a nursing
facility” or the services of different institutions).
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199
Thomas, J., dissenting
The ubiquity of such spending conditions, combined with
the
Federal Government's overwhelming fnancial heft, has
made Spending Clause legislation an extraordinarily potent
instrument of federal control.
2
Congress and federal agen-
cies “regularly us[e] conditions to direct state and local
governments in their regulatory and spending policies.”
P. Hamburger, Purchasing Submission 139 (2021) (Ham-
burger). As a result, “the priorities and programs of state
and local governments have increasingly come to refect fed-
eral decisions,” to the point that the States have virtually
become “disaggregated sites of national governance, not sep-
arate sovereigns.” Id., at 141 (internal quotation marks
omitted). Given the profound consequences of spending
conditions for the Nation's governance and the fundamental
shift that they have wrought in our federalist system, a
sound understanding of their constitutional basis and permis-
sible legal effects is essential.
II
This case presents one aspect of that question: whether
spending conditions that impose obligations on States for the
2
The power of this tool has grown with the steady increase in federal
income-tax revenues since the adoption of the Sixteenth Amendment. Al-
though the Revenue Act of 1913 accounted for only 10% of federal revenue,
by 1950, the income tax was the Nation's largest source of revenue, and,
by 2010, it accounted for a whopping 82% of federal revenue overall. E.
Jensen, Did the Sixteenth Amendment Ever Matter? Does It Matter
Today? 108 Nw. U. L. Rev. 799, 807, n. 44 (2014). This explosion of funds
created unprecedented threats to federalism due to the increased use of
grants. Federal “[m]onetary grants, so-called grants-in-aid, became more
frequent during the 1930's, and by 1950 they had reached $20 billion or
11.6% of state and local government expenditures.” National Federation
of Independent Business v. Sebelius, 567 U. S. 519, 674 (2012) (NFIB)
( joint dissent of Scalia, Kennedy, Thomas, and Alito, JJ.) (citation and
footnote omitted). “By 1970 this number had grown to $123.7 billion or
29.1% of state and local government expenditures . . . . As of 2010, federal
outlays to state and local governments came to over $608 billion or 37.5%
of state and local government expenditures.” Ibid. (footnote omitted).
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beneft of third parties may be enforced under § 1983. That
st
atute provides a cause of action against any “person who,
under color” of state law, deprives the plaintiff “of any
rights, privileges, or immunities secured by the Constitution
and laws.” Accordingly, for the violation of a federal statu-
tory provision to give rise to a cognizable § 1983 claim, the
provision must confer “rights, privileges, or immunities” that
are “secured by . . . la[w].” This Court's cases make clear
that a right is secured by law in the relevant sense if, and
only if, federal law imposes a binding obligation on the de-
fendant to respect a corresponding substantive right that be-
longs to the plaintiff.
3
In Thiboutot, the Court held that “the plain language of
[§ 1983] undoubtedly embraces [a] claim that [the defendant]
violated” a spending-power statute, reasoning that “the
phrase `and laws' . . . means what it says” and is not “limited
to some subset of laws.” 448 U. S., at 4. The Court un-
questioningly follows Thiboutot's logic today.
It is obvious, however, that conditional spending legisla-
tion does not function—and, in particular, does not “secure
rights”—like laws enacted under Congress' enumerated leg-
islative powers, such as the Commerce Clause. The latter,
3
See Golden State Transit Corp. v. Los Angeles, 493 U. S. 103, 106 (1989)
(“[T]he plaintiff must assert the violation of a federal right. . . . In deciding
whether a federal right has been violated, we have considered whether
the provision in question creates obligations binding on the governmental
unit” and “whether the provision in question was intended to beneft the
putative plaintiff ” (alteration and internal quotation marks omitted));
Pennhurst State School and Hospital v. Halderman, 451 U. S. 1, 15, 16,
n. 12, 18–19 (1981) (repeatedly using the formula “rights and obligations”
correlatively); see also W. Hohfeld, Some Fundamental Legal Conceptions
as Applied in Judicial Reasoning, 23 Yale L. J. 16, 28–32 (1913). This rule,
it should be noted, addresses what it means for private rights to be se-
cured by law, a distinct question from the level of clarity with which Con-
gress must speak before courts may infer that it intended to create such
rights. See Gonzaga Univ. v. Doe, 536 U. S. 273, 290 (2002).
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Thomas, J., dissenting
which I will refer to as “sovereign legislative” or “regula-
tory”
powers, include powers to directly impose obligations,
duties, prohibitions, and the like on individuals and entities
beyond the Federal Government, and hence to secure corre-
sponding rights in the persons and entities to which such
obligations are owed. Laws that Congress enacts pursuant
to its regulatory powers are binding on the regulated parties
and pre-empt contrary state law of their own force. What-
ever rights such laws secure, those rights are secured “by
the . . . laws” themselves. § 1983.
By contrast, legislation that conditions a State's receipt of
federal funds on compliance with certain requirements im-
poses no obligations and secures no rights of its own force.
The stated conditions simply have no effect and do not argua-
bly secure any rights (“by law” or otherwise) unless and until
they are freely accepted by the State. Not only that, the
Executive Branch can prevent the conditions from taking ef-
fect by rejecting a State's application to participate in the
spending program, and it can terminate their effect by cut-
ting off a State's participation for noncompliance with the
conditions. In addition, States can opt out of spending pro-
grams, completely nullifying whatever force the spending
conditions once had. This alone suggests that spending con-
ditions do not operate with the force of federal law, as “Con-
gress' legislative powers cannot be avoided by simply opting
out.” D. Engdahl, The Contract Thesis of the Federal
Spending Power, 52 S. D. L. Rev. 496, 498 (2007) (emphasis
deleted); see also Townsend v. Swank, 404 U. S. 282, 292
(1971) (Burger, C. J., concurring in result) (“[A]dherence to
the provisions of [spending statutes] is in no way mandatory
upon the States under the Supremacy Clause”).
Indeed, spending conditions like those in FNHRA do not
function as laws enacted under Congress' regulatory powers,
and, if they did, they would unconstitutionally commandeer
the States to administer federal programs ranging from wel-
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fare, to healthcare, to air quality, and much more. Such con-
diti
ons are thus constitutional, if at all, only if understood as
setting forth the terms of a federal-state contract, rather
than as binding federal law imposing legally enforceable obli-
gations of its own force. In holding that FNHRA secures
rights by federal law, the majority ignores the contractual
understanding of spending conditions and, by doing so, calls
their very constitutionality into question.
A
As noted earlier, a defning characteristic of modern
spending legislation is the imposition of obligations on States
that accept federal funds. Understanding a State's breach
of such obligations as akin to violating rights secured by fed-
eral law is incompatible with this Court's anticommandeer-
ing doctrine. Under this bedrock constitutional principle,
Congress generally cannot directly regulate the States or
require them to implement federal programs.
“When the original States declared their independence,
they claimed the powers inherent in sovereignty.” Murphy
v. National Collegiate Athletic Assn., 584 U. S. –––, –––
(2018) (citing Declaration of Independence ¶32).
4
Later, in
ratifying the Constitution, the people of the original States
granted carefully enumerated legislative powers to the new
Federal Congress, while preserving the States' pre-existing
legislative power. 584 U. S., at –––. “[C]onspicuously ab-
4
The Articles of Confederation granted Congress only the power to act
upon States; it had no power to directly regulate individuals. The Consti-
tution fipped this arrangement by granting the Federal Government the
power to regulate individuals directly, but not States. See New York v.
United States, 505 U. S. 144, 162 (1992) (“ `The people, through [the Consti-
tution], established a more perfect union by substituting a national govern-
ment, acting, with ample power, directly upon the citizens, instead of the
Confederate government, which acted with powers, greatly restricted,
only upon the States' ” (quoting Lane County v. Oregon, 7 Wall. 71, 76
(1869); emphasis deleted)).
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sent from” Congress' enumerated powers was “the power to
issue
direct orders to the governments of the States.” Ibid.
Thus, as this Court has made clear, the Constitution “con-
fers upon Congress the power to regulate individuals, not
States.” New York v. United States, 505 U. S. 144, 166
(1992).
5
As a corollary, Congress “may not conscript state
governments as its agents,” nor can it “require the States to
govern according to [its] instructions.” Id., at 162, 178.
And, “[w]hatever the outer limits of [state] sovereignty may
be, one thing is clear: The Federal Government may not com-
pel the States to enact or administer a federal regulatory
program.” Id., at 188.
6
Yet that is precisely what many spending conditions re-
quire the State to do. Spending conditions like FNHRA's
are nothing more than commands to States, qua States, to
administer federal benefts programs on terms dictated by
Congress. Such conditions cannot be treated as having the
force of federal law imposing direct obligations on the States
and securing correlative rights of private parties without vi-
olating the anticommandeering doctrine.
It is no answer that the States consent to direct regulation
by agreeing to the spending conditions in return for federal
dollars. As the Court held in New York, “[w]here Congress
exceeds its authority relative to the States, . . . the departure
from the constitutional plan cannot be ratifed by the `con-
sent' of state offcials.” Id., at 182. Because the people
5
Congress possesses limited powers to directly regulate the States
under the Reconstruction Amendments. See, e. g., City of Boerne v. Flo-
res, 521 U. S. 507, 518 (1997). Due to the federalism concerns inherent in
such regulation, these enforcement powers are cabined by the congruence-
and-proportionality test. Id., at 518–519. The careful tailoring of this
exception vividly proves the rule.
6
The anticommandeering doctrine protects “political subdivisions” of
States against federal cooptation, as well as the States themselves.
Printz v. United States, 521 U. S. 898, 935 (1997); see also id., at 931, n. 15
(“[T]he distinction in our Eleventh Amendment jurisprudence between
States and municipalities is of no relevance here”).
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have surrendered only limited and enumerated powers to the
F
ederal Government, the States and Congress cannot jointly
circumvent the ratifcation and amendment process by agree-
ing “to the enlargement of the powers of Congress beyond
those enumerated in the Constitution.” Ibid. The Federal
Government cannot buy (or rent) the States' power to imple-
ment a federal program and then regard the conditions that
the States are implementing themselves as having the force
of federal law.
B
Of course, it is ultimately the States' consent that gives
effect to conditions in spending legislation, but it does so
in an entirely different manner from an illicit expansion of
Congress' regulatory powers. Rather, as the Court ob-
served in Pennhurst State School and Hospital v. Halder-
man, 451 U. S. 1 (1981), “legislation enacted pursuant to the
spending power is much in the nature of a contract.” Id., at
17. A federal statute imposing conditions upon the receipt
of federal funding does not enact those conditions with “the
obligation of law”; it merely “proposes them as the terms
of a contractual promise.” Hamburger 132. Such spending
provisions “merely stipulate what the government expects
from recipients if it is to pay them or, later, not withhold
further payment and demand its money back.” Ibid. Thus,
“even when fully recited in statutes, federal conditions do
not come with legal obligation.” Ibid.
Further, and as already noted, the conditions in spending
legislation only come into force upon the acceptance of an-
other party. Such conditions are thus “obligatory only by
virtue of such agreement and not by force of law.” D. Eng-
dahl, The Spending Power, 44 Duke L. J. 1, 104 (1994). To
be sure, “it is a statute that prescribes the funding condition
and requires denial of federal assistance if the funding condi-
tion is not agreed to.” Ibid. But, “only the agreement—
and not the statute—makes the terms obligatory on the
funds recipient and thus `secures' the contemplated third-
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party rights.” Ibid.
7
A
ccordingly, such “third-party rights
. . . are `secured' (if at all) not by any `law,' but only by the
contract between the recipient and the United States.”
Ibid.
This contractual understanding of conditional spending
legislation is much more than a mere analogy; it is the only
possible explanation for why such legislation is not an uncon-
stitutional direct regulation of the States. To deny or down-
play this principle is to seek to have it both ways. Much
spending legislation conditions States' receipt of federal
funds on their undertaking obligations with respect to third
parties. For such legislation to survive a federalism chal-
lenge, it must not directly impose obligations on the States
with the force of federal law. But, for those conditions to
be enforceable under § 1983, they must secure third-party
rights by directly imposing correlative obligations on the
States with the force of federal law. Both of these things
cannot be true.
III
This contractual understanding of spending conditions is
also a necessary consequence of the limited nature of Con-
7
For this reason, the mere fact that spending conditions are enacted
in statutory form is irrelevant; “not everything in a statute is legally bind-
ing.” Hamburger 131; see also D. Engdahl, The Contract Thesis of the
Federal Spending Power, 52 S. D. L. Rev. 496, 500 (2007). In other words,
while Congress may infuence policy “by attaching `strings' to grants of
money given to state and local governments, . . . those strings aren't laws,”
and do not secure rights, in the sense needed to support § 1983 liability.
United States v. Morgan, 230 F. 3d 1067, 1073 (CA8 2000) (Bye, J., specially
concurring); see also Westside Mothers v. Haveman, 133 F. Supp. 2d 549,
581–582 (ED Mich. 2001) (“[N]o interest is `secured' by the federal Medi-
caid statute. Upon its enactment, this federal law does not vest in a sin-
gle American the right or privilege of receiving federally-subsidized medi-
cal care. . . . [T]hough passed by both houses of Congress and signed by
the President, the Medicaid statute has no force of its own. It is only
when a State . . . accepts the Federal Government's offer and agrees to
participate in the program that any benefts accrue to eligible individu-
als”), rev'd, 289 F. 3d 852 (CA6 2002).
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gress' spending power, as consistently understood for nearly
two
centuries of our Nation's history. Indeed, this is one
point on which the Framers all seem to have agreed. De-
spite heated debates over the source and scope of Congress'
power to spend, all understood that this power did not carry
with it any independent regulatory authority. That agree-
ment persisted throughout the 19th century. And, in the
20th, it was a critical underpinning of this Court's precedents
upholding expansive uses of the spending power as consist-
ent with Congress' limited legislative powers and our feder-
alist system of government.
A
At the outset, while Congress undoubtedly possesses the
power to direct the expenditure of federal funds, it is impor-
tant to note that the Constitution contains no “spending
clause.” From the beginning, some have located the spend-
ing power in the General Welfare Clause, and that view has
generally been accepted by this Court's modern doctrine.
See Engdahl, 44 Duke L. J., at 53, and n. 220 (describing
Alexander Hamilton's views); South Dakota v. Dole, 483
U. S. 203, 206 (1987). Yet, there are serious problems with
that view.
The General Welfare Clause is simply part of the Taxing
Clause, which reads in relevant part: “The Congress shall
have Power To lay and collect Taxes, Duties, Imposts and
Excises, to pay the Debts and provide for the common De-
fence and general Welfare of the United States.” Art. 1, § 8,
cl. 1. By its terms, the only authority vested by this text is
a power to “lay and collect Taxes, Duties, Imposts and Ex-
cises.” This power is then qualifed by the Debts and Gen-
eral Welfare Clauses, which limit the objects for which Con-
gress can exercise that power. The General Welfare Clause
is thus most naturally read as a qualifcation on the substan-
tive taxing power.
Consider also that the General Welfare Clause references
not only the “general Welfare” but also “the common De-
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fence.” If the Clause were construed as an affrmative
grant
of power to spend for the common defense, it would
make redundant Congress' powers to “raise and support Ar-
mies” and to “provide and maintain a Navy,” also found in
Article I, § 8, cls. 12–13. Thus, “[i]f the reference to `com-
mon Defence' spending simply alludes to power conferred
elsewhere,” then it seems illogical to consider the terms
“general Welfare” as the source of a freestanding power to
spend for whatever purposes. D. Engdahl, The Basis of the
Spending Power, 18 Seattle U. L. Rev. 215, 222 (1995).
The Taxing Clause is also a strange candidate for the
source of a general congressional spending power because “it
fails to provide any authority at all to spend money acquired
otherwise than by taxation.” Ibid. Yet, “[t]he federal
treasury receives money from many other sources, including
penalties, fnes, user fees, leases, surplus property sales,
gifts, bequests, and returns on investments.” Ibid. And
those sums are a pittance in comparison to those raised
under Congress' Borrowing Clause power, see Art. I., § 8,
cl. 2, which has always been one of the major sources of fed-
eral funds. Unless federal spending on credit and from rev-
enues not derived from “Taxes, Duties, Imposts and Excises”
is unconstitutional, the General Welfare Clause cannot be the
source of Congress' spending power.
The Clause certainly is not an independent grant of regu-
latory power to legislate for the general welfare, as the his-
tory of the Constitution's framing and ratifcation makes
clear. The Philadelphia Convention initially adopted a reso-
lution that Congress be authorized “ `to legislate in all cases
for the general interests of the Union, and also in those to
which the States are separately incompetent, or in which the
harmony of the United States may be interrupted by the
exercise of individual legislation.' ” J. Renz, What Spending
Clause? (Or the President's Paramour), 33 John Marshall
L. Rev. 81, 104 (1999) (Renz). But the Convention later
abandoned this vesting of a broad power to legislate for the
general welfare in favor of the enumeration of specifc fed-
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eral legislative powers and the creation of a taxing power
l
imited by the General Welfare Clause. See R. Natelson,
The General Welfare Clause and the Public Trust: An Essay
in Original Understanding, 52 Kan. L. Rev. 1, 23–29 (2003)
(Natelson); see also Renz 104–105 (counting fve instances
in which the Convention considered and rejected attempts
“to insert a grant of general legislative power into the
Constitution”).
8
Consistent with its text, Federalist advocates of the Con-
stitution defended the General Welfare Clause to the ratify-
ing public as nothing more than a limitation on the taxing
power. See, e. g., 3 Debates on the Constitution 207 (J. El-
liot ed. 1876) (Elliot's Debates) (E. Randolph, Virginia Con-
vention) (“The plain and obvious meaning of this is, that no
more duties, taxes, imposts, and excises, shall be laid, than
are suffcient to pay the debts, and provide for the common
defence and general welfare, of the United States”); N. Web-
ster, An Examination Into the Leading Principles of the Fed-
eral Constitution, in Pamphlets on the Constitution of the
United States 50 (P. Ford ed. 1888) (“[I]n the very clause
which gives the power of levying duties and taxes, the pur-
poses to which the money shall be appropriated are specifed,
viz. to pay the debts and provide for the common defence
and general welfare of the United States”); see also Natelson
47–49. “[T]heir basic message was that the language in
question was not a grant at all—rather it was a restriction
on federal authority.” Id., at 39. As Governor Randolph
emphatically declared: “Is this an independent, separate,
8
One instance in particular demonstrates that the General Welfare
Clause is simply a restriction on the Taxing Clause. The Committee of
Style slightly altered the text agreed to by the Convention by changing
the comma after “Excises” into a semicolon, so that the General Welfare
Clause “became an additional power, conjoined to the power to tax, rather
than merely a limitation on it.” Hamburger 283. The Convention, how-
ever, recognized the alteration and restored the comma, “corroborat[ing]
the conclusion that the General Welfare Clause was not an independent
power.” Natelson 28.
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substantive power, to provide for the general welfare of the
U
nited States? No, sir.” 3 Elliot's Debates 466.
Federalists went out of their way to specifcally disclaim
that the General Welfare Clause would vest any independent
regulatory power. For example, James Madison expressly
rejected Anti-Federalist attempts to portray the General
Welfare Clause as granting “an unlimited commission to ex-
ercise every power which may be alleged to be necessary for
the common defense or general welfare.” The Federalist
No. 41, p. 262 (C. Rossiter ed. 1961). Similarly, in rebutting
Patrick Henry's warning that the Clause would vest a regu-
latory power, Governor Randolph observed: “You must vio-
late every rule of construction and common sense, if you
sever it from the power of raising money, and annex it to any
thing else, in order to make it that formidable power which
it is represented to be.” 3 Elliot's Debates 600. Again and
again, leading Federalists represented the General Welfare
Clause simply “as qualifying the fscal power.” E. Corwin,
The Spending Power of Congress—Apropos the Maternity
Act, 36 Harv. L. Rev. 548, 552 (1923) (citing The Federalist
Nos. 30 and 34 (A. Hamilton), and 41 (J. Madison)). “It was
generally understood” by the Constitution's ratifers “that
the General Welfare Clause did not confer power to regu-
late”; such regulatory powers were conferred only by specifc
enumerations such as the Commerce Clause. T. Sky, To
Provide for the General Welfare 67 (2003) (Sky).
Thus, even if one implausibly regards the General Welfare
Clause as a “Spending Clause,” it is unambiguous that the
Clause confers no independent regulatory power. Impor-
tantly, the same holds for every other plausible textual an-
chor for Congress' general spending power. First, the Nec-
essary and Proper Clause is a natural candidate for the
spending power because spending funds may be “necessary
and proper for carrying into Execution” the Federal Govern-
ment's enumerated powers. Art. I, § 8, cl. 18; see G. Law-
son & G. Seidman, The Constitution of Empire 30 (2004)
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(Lawson & Seidman) (“This `Sweeping Clause' . . . unques-
ti
onably includes the power to enact spending laws that
are `necessary and proper' for effectuating federal powers”);
K. Stith, Congress' Power of the Purse, 97 Yale L. J. 1343,
1348 (1988) (arguing that the Necessary and Proper Clause
“includes the power to spend public funds on authorized fed-
eral activities”). But, because the Clause authorizes only
those spending measures that are “ `necessary and proper for
carrying into Execution' other enumerated federal powers[,]
Congress can . . . spend only if the appropriation is tied to
the execution of one of the federal government's granted
powers.” Lawson & Seidman 30. The Clause thus “does
not provide a stand-alone grant of spending authority, and
certainly not an authority to spend for a nonspecifc `general
welfare of the United States.' ” Ibid.
A second plausible source of the spending power is the
Property Clause, which provides that “Congress shall have
Power to dispose of and make all needful Rules and Regula-
tions respecting the Territory or other Property belonging
to the United States.” Art. IV, § 3, cl. 2. The term “other
Property” may “comprehen[d] personal property no less than
real,” and “personal property includes money, as well as f-
nancial assets of all kinds.” Engdahl, 18 Seattle U. L. Rev.,
at 250 (emphasis deleted). But the power to dispose of funds
does not carry with it any regulatory power; the Property
Clause “only authorizes the control and disposition of federal
property” and “does not disturb the allocation of governance
authority otherwise accomplished under the principle of enu-
merated powers.” Id., at 251. Thus, when disposing of fed-
eral property under the Property Clause, “Congress has no
more competence to make `law' than any private donor or
testator has.” Engdahl, 44 Duke L. J., at 104.
B
In the early decades after ratifcation, both the source and
the scope of the spending power were hotly contested, usu-
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ally in debates over “internal improvements” such as roads
and
canals. One side, represented by Madison, maintained
that federal spending must be strictly in aid of the Federal
Government's specifcally enumerated powers—for instance,
expenditures to construct a road would be justifed only if
the road could be constructed under the Post Roads Clause
or some other enumerated power. See Renz 108–119; see
also J. Eastman, Restoring the “General” to the General Wel-
fare Clause, 4 Chap. L. Rev. 63, 72 (2001). As this side of the
debate also took a narrow view of the enumerated powers,
it generally argued that the Federal Government could not
fund internal improvements without a constitutional amend-
ment. See Sky 140–141. The other camp, associated with
the nationalist views of Hamilton and Joseph Story, under-
stood the General Welfare Clause to “include very broad
spending authority,” which could be applied to purposes not
specifcally enumerated by the Constitution. Natelson 12;
see also Renz 124–126.
Even this camp, however, understood that “the General
Welfare Clause does not include a power to regulate.” Natel-
son 12; see also Sky 96. Hamilton, for example, made clear
that the spending power did not “imply a power to do what-
ever else should appear to Congress conducive to the general
welfare.” Report on the Subject of Manufactures 37 (1791).
As he further elaborated, “[a] power to appropriate money
[does] not carry a power to do any other thing, not authorized
in the Constitution, either expressly or by fair implication.”
Ibid. Instead, any regulatory authority had to be tethered
to some independent regulatory power. Thus, under this
view, Congress could spend money on roads and canals un-
connected with the enumerated powers, but it would have to
depend on the States for any regulatory legislation needed
to complete and preserve the improvements.
This understanding that the spending power itself ex-
tended only to the “application of money,” ibid. (emphasis
in original), led Hamilton to favor a constitutional amend-
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ment “empowering Congress to open canals.” Letter from
A.
Hamilton to J. Dayton (1799), in 10 Works of Alexander
Hamilton 334 (H. Lodge ed. 1904). After all, opening canals
“involve[d] much more than spending money: it involve[d]
acquiring rights of way and constructing and operating the
improvements.” Engdahl, 44 Duke L. J., at 23. Thus, it
was precisely the “insuffciency of the spending power to
override state law obstacles to achieving the targeted end
that made Hamilton conclude that a constitutional amend-
ment for canals was necessary.” Id., at 24. “[F]ederal
funding alone” could not “override” “incompatible or adverse
state policies.” Ibid. As this example demonstrates, even
those who held the broadest conception of the spending
power recognized that it was only a power to spend, not a
power to impose binding requirements with the force of fed-
eral law. See Sky 95.
The limited nature of the spending power was also a rare
point of agreement in Hamilton and Jefferson's bitter quarrel
over the constitutionality of a national bank. Refecting the
ratifcation era understanding of the General Welfare Clause,
Jefferson observed that “the laying of taxes is the power and
the general welfare the purpose for which the power is to be
exercised.” Opinion on the Constitutionality of the Bill for
Establishing a National Bank (Feb. 15, 1791), in 19 Papers of
Thomas Jefferson 277 (J. Boyd ed. 1974) (emphasis in origi-
nal). If the General Welfare Clause went beyond “describ-
ing the purpose of the” Taxing Clause and represented “a
distinct and independent power to do any act [Congress may]
please, which might be for the good of the Union,” it “would
render all the preceding and subsequent enumerations of
power completely useless.” Ibid.; accord, J. Madison, The
Bank Bill (Feb. 2, 1791), in 13 Papers of James Madison 375
(C. Hobson & R. Rutland eds. 1981) (interpreting the General
Welfare Clause as a distinct power “would supersede all the
powers reserved to the state governments”). In response,
Hamilton justifed the bank based on Congress' enumerated
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powers, such as the Commerce and Taxing Clauses. Opin-
i
on on the Constitutionality of an Act To Establish a Bank
(Feb. 23, 1791), in 8 Papers of Alexander Hamilton 97 (H.
Syrett ed. 1965). He discussed the General Welfare Clause
only as a limitation: “It is true, that [Congress] cannot with-
out breach of trust, lay taxes for any other purpose than
the general welfare.” Id., at 129. In his view, the spending
power was emphatically limited to “the application of
money.” Ibid. (emphasis in original). Jefferson and Hamil-
ton could agree that it was no independent font of legisla-
tive power.
In sum, the Framers and Ratifers understood the Taxing
and General Welfare Clauses as granting only a power to tax.
What our modern cases refer to as the “Spending Clause”—
in fact, the General Welfare Clause—was understood by the
Framers and the ratifying public as granting no regulatory
authority. One thing that the opposing men and factions of
the founding generation agreed upon was that the Federal
Government's power to spend was just that—a power to
spend, involving no reg ulatory authority. Instead, the
power to bind with the force of law must come from Con-
gress' enumerated legislative powers rather than its spend-
ing power.
C
Though the scope and source of the spending power contin-
ued to be vigorously contested into the 19th century, the fun-
damental understanding that federal spending measures
could not bind with the force of law remained common
ground. For example, in his last offcial act, President Madi-
son vetoed an internal improvements bill in part because
the “train of powers incident” to constructing and maintain-
ing such improvements were beyond Congress' enumerated
powers. 30 Annals of Cong. 211, 212 (1817). The General
Welfare Clause could not provide the needed regulatory au-
thority, as such an interpretation “would have the effect of
giving to Congress a general power of legislation,” thus ren-
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dering the Constitution's “special and careful enumeration of
powers
. . . nugatory and improper.” Id., at 212. That the
bill required state consent was likewise insuffcient because,
if the power “be not possessed by Congress, the assent of
the States . . . cannot confer the power.” Ibid.
Upon assuming offce, President James Monroe sent a mes-
sage to Congress agreeing with Madison's views; the mes-
sage was then referred to a special Committee in the House
of Representatives led by Congressman Henry Tucker.
Corwin, 36 Harv. L. Rev., at 559–560. The Tucker Commit-
tee produced an exhaustive report on internal improve-
ments, which disagreed with nearly every aspect of Madison
and Monroe's position. Id., at 560–561. Signifcantly, how-
ever, the Committee agreed that the General Welfare Clause
did not vest the power needed to make internal improve-
ments, relying instead on the Constitution's specifc enumer-
ations such as the Post Roads Clause. 31 Annals of Cong.
454 (1817) (“disavow[ing] any use of the general phrase in the
Constitution to provide for the common defence and general
welfare, as applicable to the enumeration of powers, or as
extending the power of Congress beyond the specifed pow-
ers”). The Tucker Committee also agreed with President
Monroe that the spending power did not “extend the speci-
fed or incidental powers of Government” or allow Congress
to exercise any “jurisdictional [i. e., regulatory] rights” over
improvements. Id., at 459–460. Thus, “if the power to
make a road or dig a canal is not given” by one of Congress'
enumerated regulatory powers, “the power of appropriating
money cannot confer it.” Id., at 459.
9
9
After a debate on the Tucker Report, the House approved a resolution
declaring Congress' authority to appropriate money to construct internal
improvements pursuant to its enumerated powers, voting down several
other resolutions that would have declared a congressional power to make
monetary grants to States untethered to any enumerated power and that
the Federal Government had the power to itself construct and maintain
internal improvements. 32 Annals of Cong. 1381–1389 (1818).

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In his second term, President Monroe set forth the fullest
expositi
on of the understanding that the spending power in-
volved no regulatory authority. In 1822, Congress passed a
bill to establish a system of internal improvements, asserting
the “power to establish turnpikes with gates and tolls, and
to enforce the collection of tolls by [federal] penalties.” Sky
147 (internal quotation marks omitted). President Monroe
then vetoed the measure, judging that Congress' spending
authority did not extend to such “a complete right of jurisdic-
tion and sovereignty for all the purposes of internal improve-
ment, and not merely the right of applying money under the
power vested in Congress to make appropriations.” 2 Mes-
sages and Papers of the Presidents 1789–1908, p. 142 (J. Rich-
ardson ed. 1897) (Richardson). Because Monroe understood
“that Congress do[es] not possess this power [and] the States
individually can not grant it,” he agreed with Madison and
Hamilton that the “power can be granted only by an amend-
ment to the Constitution.” Id., at 143.
To explain his veto, President Monroe sent Congress an
extensive report entitled “Views of the President of the
United States on the Subject of Internal Improvements.”
In this report—perhaps “the most elaborate constitutional
discussion ever sent to the Capitol from the White House”—
Monroe synthesized the understanding of the spending
power from the founding of the Republic. L. Rogers, The
Postal Power of Congress 75 (1916). And, in doing so, he
largely settled the contours of that understanding for over
a century.
In the centerpiece of the Views, Monroe explained that
the spending power carries no incidental power to regulate
individuals or States. Echoing Hamilton, Monroe under-
stood the spending power to consist of “a right to appro-
priate the public money, and nothing more.” Richardson
162. It carries with it “no incidental power, nor does it draw
after it any consequences of that kind.” Id., at 168. Mon-
roe proceeded to carefully distinguish the spending power
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from Congress' authority to impose obligations and duties:
“
[T]he use or application of the money after it is raised is a
power altogether of a different character” from Congress'
enumerated regulatory powers such as the taxing power;
“[i]t imposes no burden on the people, nor can it act on them
in a sense to take power from the States.” Id., at 164.
Applying this understanding of the spending power to the
question of internal improvements, Monroe explained that
Congress could only “appropriate the money necessary to
make them.” Id., at 168. Where none of Congress' enu-
merated regulatory powers was applicable, Monroe con-
cluded, “[f]or every act requiring legislative sanction or sup-
port the State authority must be relied on.” Ibid. Thus,
Congress could not itself pass laws providing for “[t]he con-
demnation of the land, . . . the establishment of turnpikes and
tolls, and the protection of the work when fnished.” Ibid.
Monroe's summation of the federal spending power, re-
fecting that it does not carry with it any regulatory power,
was accepted throughout the 19th century by friends and
foes of federal power alike. In his 1825 inaugural address,
President John Quincy Adams explained that Monroe's Views
had “conciliated the sentiments and approximated the opin-
ions of enlightened minds upon the question of constitutional
power.” Inaugural Address, Mar. 4, 1825, in 5 American
State Papers, Foreign Relations 753, 755 (1858). Five years
later, President Andrew Jackson vetoed the Maysville Road
Bill of 1830 for the same reasons Monroe had vetoed the
Cumberland Road Bill of 1822: Congress lacks “[t]he right to
exercise as much jurisdiction as is necessary to preserve the
works and to raise funds by the collection of tolls to keep
them in repair,” and “[w]ithout [such power] nothing exten-
sively useful can be effected.” Richardson 492.
Justice Joseph Story's Commentaries on the Constitution
also recognized that the spending power did not carry with
it any auxiliary power to bind individuals or States. Citing
Monroe's Views liberally, Story agreed that Congress could

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not enact a system of internal improvements under the Gen-
era
l Welfare Clause. Although he located the spending
power in that Clause, Story understood that the power was
confned “to mere appropriations of money,” and that, as a
result, the Federal Government could not regulate internal
improvements except pursuant to its legislative “enumerated
powers.” 3 Commentaries on the Constitution of the United
States, § 1269, p. 150 (1833); see also Sky 224 (“[A]s read by
Story, the General Welfare Clause did not constitute a regu-
latory power, independent of the spending power, authoriz-
ing Congress to enact whatever measures it wished . . . under
an unlimited power to legislate for the general welfare of the
United States”).
Although disagreement on whether Congress could spend
for purposes beyond the enumerated powers persisted
through the Antebellum and Reconstruction eras, the under-
standing that the spending power did not imply regulatory
power persisted. See generally Sky 232–240, 270–291. Be-
cause Congress was acting solely under its power to spend,
it relied on the States' acceptance of terms and upon the
States' legislative powers to carry out federal spending
programs.
D
Given this consensus, it is not surprising that the frst fed-
eral grant-in-aid spending programs were contractual in na-
ture. The Morrill Act of 1862, perhaps the frst such pro-
gram, extended an offer to the States to accept donations of
federal lands on the condition that the State use the land to
establish a college. 12 Stat. 504–505. States had two years
to accept the federal terms in the form of an Act by the
State's legislature. Id., at 505 Signifcantly, the only con-
sequence for a State's breach of the use condition was con-
tractual in nature—“the grant to such State shall cease; and
said State shall be bound to pay the United States the
amount received of any lands previously sold.” Id., at 504–
505. The Second Morrill Act, enacted in 1890, followed the

218 HEAL
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same framework, donating money for the endowment of ag-
r
icultural and mechanical arts colleges, subject to the condi-
tion that black students not be excluded. Ch. 841, 26 Stat.
417. Like the First Morrill Act, the only consequence for
noncompliance was that future appropriations under the Act
would cease until the State brought itself into compliance.
Id., at 419.
In the early 20th century, the adoption of the Sixteenth
Amendment and the national income tax vastly expanded the
revenue available to the Federal Government. But the in-
creasingly ambitious spending programs that followed did
not break the contractual pattern established by the Morrill
Acts. Thus, early-20th-century highway grants took the
form of an offer to enter a contract, with the consequence of
noncompliance being the cutoff of federal funds. See Cor-
win, 36 Harv. L. Rev., at 574, n. 72 (describing Federal High-
way Act of 1916); see also id., at 573–575 (collecting other
examples).
Even in the New Deal era, advocates of far-reaching
spending programs continued to understand the spending
power as a mere power of appropriation. Professor Corwin,
for example, recognized that the States must be depended
upon to exercise the legislative power needed to implement
such programs. Thus, “federal highway construction re-
lie[d] on the state power of eminent domain, as well as on
state power to police and protect highways during and after
their construction.” National-State Cooperation—Its Pres-
ent Possibilities, 46 Yale L. J. 599, 617 (1937). Similarly, na-
tional protection of forests depended on “the power of the
states to regulate the conduct of persons entering forests,”
and the provision of maternity benefts depended on “the
power of the cooperating states to compel birth registration,
the licensing of mid-wives, etc.” Ibid. Thus, more than
100 years after Monroe's Views, it was still well understood
that the Federal Government's spending power needed to
work with “the wider coercive powers of the states” to ac-
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complish its ends. Ibid. And, a State's acceptance of fed-
era
l funds in return for exercising its own powers did not
expand the Federal Government's legislative powers.
In sum, from the framing of the Constitution to well into
the 20th century, it was virtually undisputed that Congress'
spending power was nothing more than a power to spend.
It included no regulatory authority to bind parties, to secure
rights or impose duties with the force of federal law, and no
authority to directly regulate the States even with their
consent.
E
When cases concerning expansive federal spending pro-
grams frst began to reach this Court, they vividly illustrated
both the enduring understanding of the spending power as
a nonregulatory power and the contractual understanding
of spending conditions. The Federal Government defended
major spending programs on the basis of that understanding,
and the programs survived this Court's review only because
of those traditional premises.
In Massachusetts v. Mellon, 262 U. S. 447 (1923), the Court
rejected as nonjusticiable Massachusetts' claim that the Ma-
ternity Act of 1921 was “an attempt to legislate outside the
powers granted to Congress by the Constitution and within
the feld of local powers exclusively reserved to the States.”
Id., at 482. The Court frst stated that it “[p]robably . . .
would be suffcient to point out that the powers of the State
are not invaded, since the statute imposes no obligation but
simply extends an option which the State is free to accept or
reject.” Id., at 480. In other words, the State could not be
injured because the Act was not a direct legal regulation.
Rather, it was a mere offer to bargain—it “imposed” no “bur-
den . . . upon the States” and did not require them “to do or
to yield anything ” of its own force. Id., at 482. The State
could not seek judicial redress because the contractual na-
ture of the Act's provisions meant that States could vindicate
their own rights “by the simple expedient of not yielding.”
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Ibid.; see also Corwin, 36 Harv. L. Rev., at 579 (noting that
the
Maternity Act adhered to the traditional requirements of
state consent and the “general caveat against jurisdictional
rights following in the wake of appropriations”). “[T]he
Justices in Mellon understood that Congress' power to spend
money is not a legislative power.” Engdahl, 52 S. D.
L. Rev., at 498 (emphasis in original).
Cases involving New Deal spending programs teach the
same lesson. For example, United States v. Butler, 297 U. S.
1 (1936), concerned the constitutionality of the Agricultural
Adjustment Act, which offered subsidies to farmers not to
sell crops. The Government defended the Act on the ground
that it did not regulate any private or state party. Instead,
“[a]ny commands or restrictions in the Act [were] imposed
only upon the use by [federal] administrative offcials of the
money granted.” Brief for United States in United States
v. Butler, O. T. 1935, No. 401, p. 264. In line with the tradi-
tional distinction between mere spending and regulatory
commands, the Government urged that “Congress ha[d] not
gone beyond its power of authorizing an expenditure” pre-
cisely because “[i]t ha[d] not sought to force or command citi-
zens to receive the money offered and to perform the condi-
tions upon which the funds are to be disbursed.” Id., at 265.
The Government expressly relied on the contractual nature
of the Act's conditions, as distinct from any “exercise of sov-
ereign regulation”:
“It would be most unusual to suppose that a contract
of this nature, entered into freely by both parties, is an
exercise of sovereign regulation and control over one of
the parties or over the subject matter with which the
contract deals. . . . The rights of the United States under
the contracts are no greater than would be the rights of
a private citizen under similar contracts, and enforce-
ment must be by ordinary judicial process according to
the law of the forum. The contracts are not derogatory
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221
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of any sovereign rights of the States; they are carried
out
pursuant to and under the protection of the laws of
the States. . . . The purpose and effect of the contracts
so entered into are simply to accomplish the spending of
the money on the conditions imposed by Congress, and
in authorizing execution of such contracts Congress was
not exerting a power outside of the feld of appropria-
tion.” Id., at 266–267.
The Government also disclaimed that the Act would have
pre-emptive effect: Because it went “no further than offering
benefts to those who comply with certain conditions,” States
“remain[ed] as free after the passage of this Act as before to
pass laws rendering it impossible for any of their inhabitants
to comply with such conditions.” Id., at 268. Thus, to
avoid a Tenth Amendment problem, the Government relied
on the traditional distinction between the Federal Govern-
ment's power to spend and its power to regulate:
“The distinction between an application of the Federal
lawmaking power to enforce compliance with the desire
of Congress and the use of the spending power to offer
benefts which might persuade people to that end [was]
recognized in this manner by th[e] frst Congresses.
.....
“When the United States goes no further than extend-
ing benefts to citizens who arrange their affairs in a
manner thought benefcial by Congress, there is no di-
rect exercise of Federal power on those affairs and they
remain subject to the unhampered control of the States.
Consequently, in a case of this nature, the effect which
the Act of Congress will have in a State is dependent
entirely upon the voluntary action of that State and its
inhabitants.” Id., at 274, 276.
In deciding the case, the Court took the Government's con-
cessions as given, stating, “[i]t is not contended that [the
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General Welfare Clause] grants power to regulate agricul-
tura
l production.” Butler, 297 U. S., at 64. The Court then
agreed with Justice Story's observation that “the only thing
granted is the power to tax for the purpose of providing
funds for payment of the nation's debts and making provision
for the general welfare.” Ibid. Congress' spending power,
even if located in the General Welfare Clause, conferred no
regulatory power.
The Court proceeded to hold the Act unconstitutional pre-
cisely because it was, in reality, “a statutory plan to regulate
and control agricultural production, a matter beyond the
powers delegated to the federal government.” Id., at 68.
That was because the “regulation [was] not in fact volun-
tary,” as it would lead to “fnancial ruin” for farmers who
refused the Act's benefts. Id., at 70–71. Confrming an-
other aspect of the traditional doctrine, the Court held that
even the purely voluntary consent of private parties could
not expand Congress' limited regulatory powers. Id., at
74–75.
10
10
The anticoercion rule refected in Butler remains a vital part of this
Court's spending-power jurisprudence. See NFIB, 567 U. S., at 575–585
(opinion of Roberts, C. J.); id., at 671–678 ( joint dissent of Scalia, Ken-
nedy, Thomas, and Alito, JJ.). As Butler makes clear, that rule is frmly
rooted in the contractual understanding of spending conditions, and NFIB
further recognized the close connection between the rule and the anticom-
mandeering doctrine when spending conditions involving States are at
issue. See NFIB, 567 U. S., at 575–585 (opinion of Roberts, C. J.); id., at
677–678 ( joint dissent). Indeed, the anticoercion rule supplements those
doctrines through its recognition of the practical realities of Congress'
modern spending power: Because the Federal Government's overwhelm-
ing fscal resources enable it to create “gun to the head” situations in
which there is no practical possibility of opting out, the rule prevents the
Government from purchasing the States' regulatory powers to implement
federal goals that it cannot attain through its own more limited powers.
Id., at 581 (opinion of Roberts, C. J.); accord, id., at 677 ( joint dissent)
(“Congress effectively engages in this impermissible compulsion when
state participation in a federal spending program is coerced, so that the
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223
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The challenge to the Social Security Act in Steward Ma-
ch
ine Co. v. Davis, 301 U. S. 548 (1937), followed a similar
pattern but reached the opposite result based on a different
level of perceived coercion. As in Butler, the Federal Gov-
ernment defended a federal statute—here, the Social Secu-
rity Act—by representing that conditions on the grant of
federal funds “are not regulatory” in nature and are thus
within the spending power. Brief for Respondent in Stew-
ard Machine Co. v. Davis, O. T. 1936, No. 837, p. 135. Seek-
ing to avoid a repeat of its loss in Butler, the Government
argued that the program was also not regulatory in fact be-
cause it did not coerce States to take or refrain from taking
any actions. Brief for Respondent in Steward Machine Co.
100, 105–106.
This time, the Court agreed with the Government, fnding
that the Act was not coercive and thus did not “go beyond
the bounds of ” Congress' spending power. Steward Machine
Co., 301 U. S., at 591–592. Then, in rejecting a federalism
challenge to the measure, the Court observed that once the
State accepted the federal conditions, it was bound with even
lesser force than an ordinary contract. Id., at 594–595.
The State was “still free, without breach of an agreement, to
change her system over night.” Id., at 595. “No offcer or
agency of the national Government [could] force a compensa-
tion law upon her or keep it in existence,” nor could they “su-
pervise or control the application of the payments.” Ibid.
11
The Court again demonstrated its adherence to the tradi-
tional view in Oklahoma v. Civil Serv. Comm'n, 330 U. S.
127 (1947). There, the U. S. Civil Service Commission de-
States' choice whether to enact or administer a federal regulatory pro-
gram is rendered illusory”).
11
Justice Sutherland's dissent recognized that the majority had applied
the traditional framework, disagreeing only with its interpretation of how
the Social Security Act actually functioned. See Steward Machine Co.,
301 U. S., at 611–612.
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termined that an Oklahoma highway commissioner had vio-
lated
the Hatch Act, pledging to withhold a portion of the
State's highway grants equal to two years' of the commis-
sioner's compensation if the State failed to remove him.
Oklahoma challenged the Commission's order and the Act on
which it was based as an illicit attempt to regulate the
State's internal affairs. Id., at 133. Citing Mellon, the
Court held that the Act was valid because it did not directly
regulate the State, which had “adopted the `simple expedi-
ent' of not yielding ” by refusing to remove its highway com-
missioner. 330 U. S., at 143.
Thus, to defend these spending programs in the frst half of
the 20th century, the Government relied on the long-settled
understanding that the power to spend carries with it no
sovereign legislative power to create rights and duties. To
the contrary, the Government represented that these pro-
grams had the binding force, at most, of contracts. They did
not pre-empt, nor did they bind States with the force of law;
they merely spent federal dollars upon conditions, the viola-
tion of which entitled the Government to cease further pay-
ments. The Court took this position as a given, and the
contractual nature of spending conditions is precisely what
saved them from constitutional challenge.
In sum, the historical record is clear and consistent on a
critical proposition: The spending power is the power to
spend only. Any duties imposed by regulatory legislation,
and any correlative rights secured by law, must fnd their
source in one of Congress' enumerated powers or the legisla-
tive powers of the States. Congress' spending power cannot
secure rights by law.
IV
The contractual nature of spending conditions was taken
as a given until the second half of the 20th century, when
individuals frst began to bring § 1983 suits premised on
violations of conditions contained within spending statutes
(usually, the Social Security Act). From the enactment of

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225
Thomas, J., dissenting
§ 1983's predecessor statute in 1871 to the Court's decision in
Th
iboutot in 1980, this Court had never held that § 1983 was
available to redress any and all violations of federal legisla-
tion. Indeed, there were almost “no square holdings” con-
cerning the precise scope of the statutory rights vindicable
by § 1983. Chapman v. Houston Welfare Rights Organiza-
tion, 441 U. S. 600, 645 (1979) (Powell, J., concurring); see
also Eisen v. Eastman, 421 F. 2d 560, 561–566 (CA2 1969)
(Friendly, J.). Perhaps the only such square holding was
that of Holt v. Indiana Mfg. Co., 176 U. S. 68 (1900), which
narrowly construed § 1983's predecessor statute to “refer to
civil rights only,” making it “inapplicable” in a suit based on
the federal patent laws. Id., at 72.
12
The traditional understanding of both the spending power
and § 1983 began slowly eroding in the 1950s, 1960s, and
1970s, culminating in Thiboutot. On the spending-power
side, the Court held in Cannon v. University of Chicago, 441
U. S. 677 (1979), that the spending conditions of Title IX of
the Education Amendments created binding duties on pri-
vate universities, the violation of which could be the ground
of a federal lawsuit by a private party. In doing so, the
12
This civil rights connection was not arbitrary. Section 1983 origi-
nated in the Enforcement Act of 1871, which Congress “passed for the
express purpose of `enforc[ing] the Provisions of the Fourteenth Amend-
ment.' ” Thiboutot, 448 U. S., at 25, n. 15 (Powell, J., dissenting) (quoting
17 Stat. 13; alteration in original). Moreover, the original text of the
statute referred only to rights “secured by the Constitution of the United
States,” 17 Stat. 13, the words “and laws” being added as part of the
general 1874 revision of the federal statutes. Rev. Stat. § 1979, 42 U. S. C.
§ 1983. Under the circumstances, there is substantial reason to doubt that
Congress fundamentally transformed a mechanism to enforce the Recon-
struction Amendments into a freestanding right of action to remediate the
violation of any federal statute, even those enacted beyond Congress' civil
rights enforcement powers. Importantly, if statutory § 1983 actions were
confned to laws enacted under Congress' Reconstruction Amendments
enforcement powers—under wh ich Congress may direc tly reg u late
States—the commandeering framework might apply differently—or not
at all.
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Court “simply ignored the crucial difference between re-
strai
nts accepted as conditions of funding, and restraints im-
posed by virtue of a legislative power.” Engdahl, 52 S. D.
L. Rev., at 509. And, on the § 1983 side, the Court had con-
sidered a number of suits against state offcials for violations
of the Social Security Act without analyzing their cognizabil-
ity under § 1983. See Thiboutot, 448 U. S., at 6 (collecting
cases); id., at 26 (Powell, J., dissenting) (“Far from being a
long-accepted fact, purely statutory § 1983 actions are an in-
vention of the last 20 years”).
The stage was thus set for Thiboutot to discard nearly two
centuries of settled spending-power doctrine by holding that
federal spending conditions secure rights by law. Ignoring
both the contractual nature of spending programs and the
enforcement-power-based understanding of § 1983, Thiboutot
declared that “the plain language of the statute undoubtedly
embrace[d] respondents' claim that [the State] violated the
Social Security Act.” Id., at 4 (majority opinion). The cen-
terpiece of the Court's opinion was its imprecise framing of
the relevant question: “whether the phrase `and laws,' as
used in § 1983, means what it says, or whether it should be
limited to some subset of laws.” Ibid. After framing the
issue thus, the Court reasoned that nothing in the legislative
history compelled limiting the term “and laws” to civil rights
laws enacted under the Reconstruction Amendments. See
id., at 6–8.
But the Court's opinion completely missed the deeper con-
ceptual question whether spending-power statutes can ever
impose obligations, and thus secure corresponding rights,
with the force of federal law.
13
As explained at length
13
In dissent, Justice Powell set out the textual and historical case for
interpreting § 1983 to apply only to rights secured by laws enacted under
Congress' enforcement powers. Thiboutot, 448 U. S., at 11; see also Chap-
man v. Houston Wel fare Rights Organization, 441 U. S. 600, 623 (1979)
(Powell, J., concurring). However, neither the Court, the parties, nor the
dissent examined whether, even if they were considered “laws” for § 1983
purposes, spending-power provisions could “secure” rights.
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Thomas, J., dissenting
above, the limited nature of the spending power dictates a
negative
answer. And, a contrary understanding would
transform the terms of federal-state agreements into binding
regulations of state entities by federal law—violating the
constitutional prohibition against directly regulating or com-
mandeering the States.
It took less than a year after Thiboutot for the Court to
realize the “ `constitutional diffculties' with imposing af-
frmative obligations on the States pursuant to the spending
power” and to take the frst step toward ameliorating the
problems with Thiboutot. Pennhurst, 451 U. S., at 17, n. 13.
In Pennhurst, the Court held that a provision of the Develop-
mentally Disabled Assistance and Bill of Rights Act (a condi-
tional spending Act) could not be enforced against a state
entity under § 1983. Id., at 18. The Court frst held that
the provision could not be considered as enforcement legisla-
tion under the Fourteenth Amendment. Id., at 16–17.
14
The Court then explained the fundamentally different na-
tures of legislation under the Reconstruction Amendments
and “legislation enacted pursuant to the spending power,”
the latter of which “is much in the nature of a contract: in
return for federal funds, the States agree to comply with
federally imposed conditions.” Id., at 17. Consistent with
the traditional position, the Court also explained that “[i]n
14
The court below had recognized but avoided the spending-power ques-
tion by holding that Congress enacted the legislation at issue pursuant
to its power to enforce the Fourteenth Amendment. See Halderman v.
Pennhurst State School and Hospital, 612 F. 2d 84, 98 (CA3 1979) (“[W]e
are not dealing with the implication of a private cause of action from a
congressional enactment justifed only by the spending power of the fed-
eral government, and we need not address the question whether such a
statute could ever provide the predicate for private substantive rights. . . .
Congress may, under section 5 [of the Fourteenth Amendment], establish
certain restrictions that might otherwise implicate the prerogatives of the
states”). The petitioners in Pennhurst squarely recognized that, if the
legislation at issue was predicated on the spending power alone, “Congress
exceeded the limits of that power.” Brief for Petitioners, O. T. 1980,
No. 79–1404, etc., p. 36, n. 57.
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legislation enacted pursuant to the spending power, the typi-
ca
l remedy for state noncompliance with federally imposed
conditions is not a private cause of action for noncompliance
but rather action by the Federal Government to terminate
funds to the State.” Id., at 28. Ultimately, because the
Pennhurst Court determined that the provision at issue was
not intended to secure rights by imposing obligations on
States, see id., at 22–27, it did not need to confront the con-
stitutional problem created by Thiboutot. Nonetheless,
Pennhurst both recognized the problem and pointed to the
solution—a return to the traditional contractual understand-
ing that itself fows naturally from the limited nature of Con-
gress' spending authority.
Without that understanding, however, it is unavoidable
that spending conditions that impose substantive obligations
on the States with the force of federal law are unconstitu-
tional.
15
As shown above, the federal spending power is
nothing more than the power to spend. It neither contains
nor implies any sovereign regulatory power to legislate
rights and duties with the force of federal law, and the regu-
lated party's consent cannot change that conclusion. The
contractual nature of the spending power was essential to
the Government's defense and this Court's approval of far-
reaching spending programs; the programs survived only
with that traditional understanding as a premise.
16
The
15
Many litigants have recognized the constitutional problems. See,
e. g., Brief for Petitioners in Gonzaga Univ. v. Doe, O. T. 2001, No. 01–679,
p. 42, n. 14 (“Nor is it clear that the conditions in Spending Clause legisla-
tion qualify as `laws' under § 1983. Such conditions only become operative
when the contract is accepted by a recipient; it is the resulting contract,
not the federal legislation itself, that gives rise to obligations and allegedly
enforceable rights”); Brief for Petitioner in National Collegiate Athletic
Assn. v. Smith, O. T. 1998, No. 98–84, p. 3; Brief for United States as
Amicus Curiae in Suter v. Artist M., O. T. 1991, No. 90–1488, p. 12, n. 6.
16
Ironically, decades after it expressly disclaimed the pre-emptive effect
of spending conditions in defending their constitutionality, see supra, at
220–221, the Federal Government argued the exact opposite in Gonzaga:
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Federal Government and private litigants cannot now dis-
card
that understanding to argue that such programs impose
obligations directly on the States that are enforceable
against state and local offcials under § 1983, without running
headlong into the anticommandeering doctrine and long-
recognized limitations on the federal spending power.
***
By holding that FNHRA creates rights enforceable under
§ 1983, the majority creates a grave constitutional problem
that cannot be brushed away with a mere incantation of Thi-
boutot. As explained above, spending-power legislation
cannot “secure” rights “by law.” Conditions on a State's re-
ceipt of federal funds are effective, not by virtue of federal
law, but by dint of a federal-state agreement. The very con-
stitutionality of such conditions depends on their eschewal of
securing rights and imposing concomitant obligations on
States.
The line from Mellon and Butler, to Thiboutot, to this case
amounts to a constitutional bait and switch that cannot con-
tinue to be glossed over or ignored. In holding that spend-
ing conditions are not merely contractual, but can directly
impose obligations on the States with the force of federal
law, the Court unravels the very rationale for their constitu-
tionality. Either conditions in statutes enacted under the
spending power are in the nature of contract terms and do
not secure rights by federal law, or they are unconstitutional
because they exceed the spending power and illicitly com-
mandeer the States. The consequence of the majority's re-
“The Act of Congress establishing the program remains binding law with
the full force and preemptive authority of federal legislation under the
Supremacy Clause, and thus falls squarely within the `laws' covered by
Section 1983 and is fully capable of `secur[ing]' rights.” Brief for United
States as Amicus Curiae in No. 01–679, p. 19 (alteration in original).
With this reversal, the Government unwittingly argued that spending con-
ditions are unconstitutional.
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jection of the contractual understanding is not that spending
conditi
ons are enforceable under § 1983. Rather, it is that
they are unconstitutional. It is well past time for this Court
to re-examine Thiboutot and the nature of Congress' spend-
ing power.
Justice Alito, w ith whom Justice Thomas joi ns,
dissenting.
I agree with the Court's understanding of the high bar
required to bring an action under 42 U. S. C. § 1983 for the
violation of a federal statute, but I disagree with how that
standard applies in this case. In my view, while respondent
has established that the Federal Nursing Home Reform Act
(FNHRA) creates individual rights, petitioners have estab-
lished that relief for the violation of those rights under § 1983
is foreclosed by the remedial scheme in the Act.
I
The majority and Justice Barrett correctly identify the
plaintiff 's burden under § 1983: a statute “must unambigu-
ously confer individual federal rights” to create “rights”
within the meaning of § 1983, and “Gonzaga sets forth our
established method for ascertaining unambiguous conferral.”
Ante, at 180, 183 (majority opinion); see ante, at 193–194
(Barrett, J., concurring); Gonzaga Univ. v. Doe, 536 U. S.
273 (2002). In other words, “if Congress wishes to create
new rights enforceable under § 1983, it must do so in clear
and unambiguous terms.” Id., at 290. Because the stand-
ard demands “no less and no more than what is required for
Congress to create new rights enforceable under an implied
private right of action,” I also agree that there is no room
for “a multifactor balancing test to pick and choose which
federal requirements may be enforced by § 1983 and which
may not.” Id., at 286, 290 (emphasis added) (rejecting the
standard articulated in Blessing v. Freestone, 520 U. S. 329,
340–341 (1997)). None of this is new ground. We have pre-
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viously held that Gonzaga “plainly repudiate[s] the ready im-
pl
ication of a § 1983 action that” our earlier decisions “exem-
plifed.” Armstrong v. Exceptional Child Center, Inc., 575
U. S. 320, 330, * (2015).
The two FNHRA provisions that respondent invokes dem-
onstrate what it takes to satisfy this demanding standard.
First, the Act mandates that a “nursing facility must protect
and promote the rights of each resident, including . . . [t]he
right to be free from . . . chemical restraints imposed for
purposes of discipline or convenience and not required to
treat the resident's medical symptoms.” 42 U. S. C.
§ 1396r(c)(1)(A). Second, the Act protects “[t]ransfer and
discharge rights,” precluding a “nursing facility” from trans-
ferring or discharging “each resident” except in certain cir-
cumstances. § 1396r(c) (2)(A) (boldface deleted). Both of
these provisions explicitly use the term “rights” to describe
discrete and concrete duties that a defned party (“nursing
facility”) owes to a particular individual (“each resident”).
When these features are taken together, they satisfy the
standard for determining whether a personal right exists.
See Gonzaga, 536 U. S., at 285–286; Alexander v. Sandoval,
532 U. S. 275, 288–289 (2001).
II
A
When determining whether individual rights are enforce-
able under § 1983, I again see much common ground with the
majority and agree entirely with Justice Barrett's expla-
nation of the governing standard. That question “boils
down to what Congress intended, as divined from text and
context.” Ante, at 187 (majority opinion). Notably, we
have explicitly held that this standard does not demand any-
thing close to the level of incompatibility required to trigger
implied repeal. See Rancho Palos Verdes v. Abrams, 544
U. S. 113, 120, and n. 2 (2005); see ante, at 194–195 (opinion
of Barrett, J.). Instead, the question is simply “whether
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Alito, J., dissenting
the rights created by a later statute `may be asserted within
the
remedial framework' of the earlier one.” Rancho Palos
Verdes, 544 U. S., at 120, n. 2; see Great American Fed.
Sav. & Loan Assn. v. Novotny, 442 U. S. 366, 375–378 (1979).
As the majority explains, § 1983 does not apply where Con-
gress has created an individual right but also “simultane-
ously given good reason (detectable with ordinary interpre-
tive tools) to conclude that the § 1983 remedy is not
available.” Ante, at 186, n. 13; see, e. g., Armstrong, 575
U. S., at 328 (presumption of equitable remedies rebutted by
administrative remedies and statutory requirements).
Finally, I agree that there is no bright-line rule for when
a statute evidences an intent to preclude § 1983 relief. See
Rancho Palos Verdes, 544 U. S., at 122; ante, at 189 (majority
opinion); ante, at 194–195 (opinion of Barrett, J.). Courts
should consider a “wide range of contextual clues, like `en-
forcement provisions' ” that government offcials can invoke
and “any `administrative remedies' that the statute offers.”
Ante, at 195 (opinion of Barrett, J.). Whatever the con-
text, the “more comprehensive the [enforcement] scheme” in
a statute, “the less likely that it leaves the door open for
§ 1983 suits.” Ibid. After all, when a statute “ `provides its
own comprehensive enforcement scheme, the requirements
of that enforcement procedure may not be bypassed by
bringing suit directly under § 1983.' ” Middlesex County
Sewerage Authority v. National Sea Clammers Assn., 453
U. S. 1, 20 (1981).
B
When all is said and done, my disagreement with the ma-
jority is thus narrowly focused on how this standard applies
to this case. In my view, FNHRA “foreclose[s] a private
cause of action” even though it “admittedly create[s] substan-
tive private rights.” Alexander, 532 U. S., at 290. The Act
creates a reticulated remedial regime that both balances fed-
eral and state enforcement and channels disputes through
that regime. Allowing § 1983 suits will upend this careful
balance.
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as: 599 U. S. 166 (2023)
233
Alito, J., dissenting
Consider the remedial provisions that the Act provides.
W
hen federal offcials fnd that a nursing home does not com-
ply with FNHRA, the Act enumerates certain limited reme-
dies they can pursue, such as withdrawing federal funding
and imposing civil penalties “in an amount not to exceed
$10,000 for each day of noncompliance.” § 1396r(h)(3)(C).
FNHRA obligates States to establish certain remedies for
noncompliance (including civil penalties), but otherwise
leaves them free to “specify criteria, as to when and how
each of [the required] remedies is to be applied, the amounts
of any fnes, and the severity of each of these remedies, to
be used in the imposition of such remedies.” § 1396r(h)
(2)(A). It also empowers States to “provide for other . . .
remedies” as they see ft. Ibid. Finally, the Act provides
“[s]pecial rules where [s]tate and [federal offcials] do not
agree on [a] fnding of noncompliance.” § 1396r(h)(6) (bold-
face deleted).
By specifying limited remedies for federal authorities and
tasking States with otherwise determining the consequences
for violations, the Act creates a clear division of authority
that ensures States retain their historical control over
nursing-home regulation. Allowing § 1983 suits will upset
this balance by allowing any plaintiff to demand damages
regardless of the remedial regime that States establish pur-
suant to their explicit authority under the Act. Moreover,
whenever a plaintiff fles suit, the determination about non-
compliance will be taken away from federal and state author-
ities and given to courts. And because the remedies offered
under § 1983 will often dwarf the relief available under
FNHRA's reticulated balance of remedies, § 1983 will swal-
low the centralized state and federal review mechanisms the
Act imposes.
The exclusivity of FNHRA's enforcement regime is but-
tressed by the grievance remedy FNHRA gives to nursing-
home residents. Residents have the “right to voice griev-
ances with respect to treatment or care” and “the right
to prompt efforts by the facility to resolve grievances.”
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234 HEAL
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Alito, J., dissenting
§ 1396r(c)(1)(A)(vi). States, in turn, are obligated to “inves-
tigate
complaints of violations of requirements by nursing
facilities” and to take enforcement actions to correct those
violations. §§ 1396r(g)(4), (h)(1); see also 42 CFR § 483.10( j)
(2021) (obligating States to provide a “grievance process”
that includes a “written decision” in response to complaints
that provides a full summary of fndings, conclusions, and
reasoning).
This grievance process dovetails neatly with FNHRA's
centralized enforcement regime because it funnels private
complaints to the same state authorities that the Act tasks
with enforcement. Indeed, respondent in this case wielded
FNHRA's grievance process to obtain relief for both of the
rights petitioners allegedly violated. See App. to Pet. for
Cert. 79a–80a. But because FNHRA's remedies are more
limited than the direct judicial highway that § 1983 offers, it
is hard to see why anyone would use them in the future.
See Rancho Palos Verdes, 544 U. S., at 122–123.
The only textual evidence the majority can identify in re-
sponse to this tailored remedial framework is FNHRA's sav-
ing clause, which states that the Act's remedies “are in addi-
tion to those otherwise available under State or Federal
law.” § 1396r(h)(8). But this provision only begs the ques-
tion whether relief under § 1983 is “otherwise available.”
We have recognized as much when holding that a materially
identical saving clause did not authorize implied remedies
under a separate remedial provision. See AMG Capital
Management, LLC v. FTC, 593 U. S. –––, ––– – ––– (2021).
And in the § 1983 context, we have similarly held that saving
clauses do “not `refer to a suit for redress of a violation of
the statut[e] at issue.' ” Rancho Palos Verdes, 544 U. S., at
126–127 (alterations omitted); accord, Sea Clammers, 453
U. S., at 20–21, n. 31.
These results are understandable. There is a consider-
able difference between preserving existing remedies for
conduct that happens to violate other laws and providing a
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as: 599 U. S. 166 (2023)
235
Alito, J., dissenting
one-stop remedy for the precise provisions in a statute. See
Al
exander, 532 U. S., at 289–290. The latter interpretation
runs against a century of holdings that a statute “ `cannot be
held to destroy itself ' ” through a saving clause. American
Telephone & Telegraph Co. v. Central Offce Telephone, Inc.,
524 U. S. 214, 227–228 (1998) (quoting Texas & Pacifc R. Co.
v. Abilene Cotton Oil Co., 204 U. S. 426, 446 (1907)). Con-
versely, concluding that FNHRA “may be enforced only
through the statute's express remed[ies]” gives full effect to
§ 1396r(h)(8) because “the claims available under § 1983 prior
to the enactment of the [Act] continue to be available.”
Rancho Palos Verdes, 544 U. S., at 126.
In short, “[a]llowing a plaintiff to circumvent [FNHRA's]
administrative remedies would be inconsistent with Con-
gress' carefully tailored scheme.” Smith v. Robinson, 468
U. S. 992, 1012 (1984). I would thus hold that the Act pre-
cludes enforcement under § 1983 and reverse the judgment
below. I therefore respectfully dissent.
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Reporter’s Note
The attached opinion has been revised to refect the usual publication
and citation style of the United States Reports. The revised pagination
makes available the offcial United States Reports citation in advance of
publication. The syllabus has been prepared by the Reporter of Decisions
for the convenience of the reader and constitutes no part of the opinion of
the Court. A list of counsel who argued or fled briefs in this case, and
who were members of the bar of this Court at the time this case was
argued, has been inserted following the syllabus. Other revisions may
include adjustments to formatting, captions, citation form, and any errant
punctuation. The following additional edits were made:
p. 167, line 4, “at” is deleted
p. 179, n. 6, line 14, “citing ” is changed to “quoting ”
p. 210, line 3 from bottom, “Rev.” is changed to “J.”
p. 211, line 15, “a” is deleted
p. 212, line 6, “Rev.” is changed to “J.”
p. 214, line 6 from bottom, “the” is deleted
p. 223, line 8, “United States” is changed to “Respondent”
p. 223, line13, “United States” is changed to “Respondent”
p. 228, line 5, “the funds” is changed to “funds”
p. 231, line 11, “treat medical symptoms” is changed to “treat the resi-
dent's medical symptoms”
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