Roberts v. EmblemHealth Neighborhood Care

Background

Jazmine I. Roberts, appearing without a lawyer, sued EmblemHealth Neighborhood Care, three Jane Doe Customer Service Representatives, and a John Doe Manager. She had been allowed to proceed without paying court filing fees in advance. Roberts alleged that HealthFirst disenrolled her after she lost special-needs status, and that she then went to EmblemHealth to reenroll in a marketplace plan. According to the complaint, she was directed among customer-service representatives and offices while trying to complete enrollment and was denied an enrollment-related reasonable accommodation.

Roberts said she needed a New York Medicaid marketplace health plan to obtain appropriate health care for her pre-existing and current medical conditions. She alleged that she was experiencing sexually transmitted disease outbreaks, interruptions in mental-health therapy, and interruptions in her psychotropic medication regimen. She identified alleged violations involving health care requirements, the Americans with Disabilities Act, and human-rights protections.

Civil-rights claims

The court construed Roberts’s civil-rights allegations as claims under 42 U.S.C. § 1983. To state such a claim, she had to allege both a violation of a federal constitutional or statutory right and action by someone acting under state law, commonly called a state actor.

The court ruled that EmblemHealth was a private, not-for-profit health insurer that contracted with New York to offer health coverage for Medicare-eligible individuals. Roberts did not allege that EmblemHealth acted under state law, and participation in Medicaid-related programs did not make the company a state actor. The court therefore dismissed the § 1983 claims against EmblemHealth for failure to state a claim.

The court also dismissed the § 1983 claims against the Jane Doe representatives and John Doe Manager. Roberts did not allege that these private individuals worked for a state or other government body, so she could not pursue § 1983 claims against them on the allegations in the complaint.

Americans with Disabilities Act claim

The court also considered Roberts’s claim under the Americans with Disabilities Act. It explained that she needed to allege facts showing that she had a qualifying disability, that the defendant was covered by the statute, and that she was denied services or otherwise discriminated against because of her disability.

The court ruled that Roberts had not provided facts showing that she had a disability as defined by the statute. Even assuming that her medical histories qualified as disabilities, the court found that she had not alleged facts connecting those conditions to the defendants’ actions. The court therefore dismissed the Americans with Disabilities Act claim for failure to state a claim.

Amendment and litigation warning

Although courts generally give a self-represented plaintiff an opportunity to amend a defective complaint, the court denied Roberts permission to amend because it concluded that the defects appeared incapable of being corrected through amendment.

The court also noted that Roberts had filed 16 actions in that court between October 7, 2020, and June 24, 2024, eight of which had been dismissed. It warned that further nonmeritorious cases could lead to an order requiring her to explain why she should not be barred from filing additional actions in that court without first obtaining permission to proceed without paying filing fees. The court did not impose that restriction in this order.

Disposition

Judge Laura Taylor Swain dismissed Roberts’s complaint for failure to state a claim under 28 U.S.C. § 1915(e)(2)(B)(ii). The court certified that an appeal would not be taken in good faith and denied fee-free status for purposes of an appeal. It directed the Clerk of Court to enter judgment.