## Facts

- Jane Cummings was deaf and legally blind and primarily communicated using American Sign Language (ASL).
- In 2016, Cummings sought physical-therapy treatment from Premier Rehab Keller, P.L.L.C., a Texas provider that received federal reimbursement through Medicare and Medicaid for some services.
- Cummings asked Premier Rehab to provide an ASL interpreter for her therapy sessions.
- Premier Rehab refused and told Cummings to communicate with the physical therapist using written notes, lipreading, or gestures.
- Cummings ultimately obtained treatment from a different provider.
- Cummings sued Premier Rehab in federal district court, alleging disability discrimination in violation of § 504 of the Rehabilitation Act and § 1557 of the Affordable Care Act, and sought damages, including compensation for emotional harms such as humiliation and frustration.
- The district court dismissed the Rehabilitation Act and ACA claims on the ground that Cummings alleged only emotional harm and emotional-distress damages are not available under those statutes’ private enforcement.
- The Fifth Circuit affirmed, and the Supreme Court granted certiorari.

## Issues

1. Whether a plaintiff may recover emotional-distress damages in a private action to enforce § 504 of the Rehabilitation Act and § 1557 of the Affordable Care Act, which incorporate Title VI’s remedies.
2. Whether, under Spending Clause “notice” principles, recipients of federal funds are on notice that accepting funds exposes them to liability for emotional-distress damages.

## Decision

- The Supreme Court affirmed the Fifth Circuit, 6–3.
- Emotional-distress damages are not recoverable in private actions to enforce the Rehabilitation Act or the Affordable Care Act’s § 1557.
- The Court treated these statutes as Spending Clause conditions operating like a contract: a funding recipient’s liability is limited to remedies it would reasonably understand were attached to the funding condition when it accepted federal money.
- Applying that contract analogy, the Court looked to remedies “traditionally available” for breach of contract to assess what recipients were on notice of.
- Because emotional-distress damages are generally not available in contract actions, recipients are not on notice that they may be liable for such damages absent a clear statutory statement.
- The Court acknowledged narrow contract-law exceptions (such as certain personal-service or dignitary contexts) but found them too limited to establish general notice for federal funding recipients.
- A concurrence agreed that the result followed from the Court’s Spending Clause remedies cases and the fair-notice requirement.
- The dissent would have allowed emotional-distress damages, reasoning that emotional and dignitary harms are a foreseeable and common result of discrimination and that recipients should expect liability for compensatory damages addressing those harms.

## Legal Principles

- Spending Clause antidiscrimination statutes operate as conditions on federal funding; remedies in private enforcement are limited by what funding recipients had clear notice of when accepting funds.
- When Congress authorizes private enforcement through Title VI–type remedial schemes, courts measure available damages by reference to remedies traditionally available for breach of contract.
- Emotional-distress damages are generally unavailable in contract law, so they are not part of the usual baseline of remedies that would give funding recipients notice of such exposure.
- Narrow exceptions permitting emotional-distress damages in certain contract settings do not create general notice sufficient to impose that remedy on recipients of federal financial assistance.
- If Congress intends to make emotional-distress damages available for violations of these funding conditions, it must do so through clear statutory authorization.

## Conclusion

The Court held that plaintiffs suing under § 504 of the Rehabilitation Act and ACA § 1557 may not recover emotional-distress damages because, under the Spending Clause contract analogy, funding recipients lack clear notice of liability for that form of compensation, which is not traditionally available in breach-of-contract actions.


Cummings v. Premier Rehab Keller, P.L.L.C., 596 U.S. , 142 S. Ct. 1562 (2022)