In Cummings v. Premier Rehab Keller, P.L.L.C., 142 S. Ct. 1562 (2022), the Supreme Court held that emotional distress damages are not recoverable in private actions to enforce the antidiscrimination provisions of the Rehabilitation Act or the Affordable Care Act.


The plaintiff, Jane Cummings, was deaf and legally blind. She asked Premier Rehab to provide, as an accommodation for her disabilities, an American Sign Language interpreter at her physical therapy sessions. Premier Rehab declined to do so.

Cummings filed suit seeking damages and other relief against Premier Rehab. She alleged that its failure to provide an ASL interpreter constituted discrimination on the basis of disability in violation of the Rehabilitation Act of 1973 and the Affordable Care Act. These statutes apply to entities that receive federal financial assistance. They therefore applied to Premier Rehab because it received reimbursement for some of its services through Medicare and Medicaid.

The District Court determined that the only compensable injuries that Premier Rehab allegedly caused Cummings were emotional in nature. The Court held that damages for emotional harm are not recoverable in private actions brought to enforce either statute, and dismissed the complaint. The Fifth Circuit affirmed. 142 S. Ct. at 1565-70.

The Court’s Decision

The Court affirmed, holding that emotional distress damages are not recoverable in a private action to enforce either the Rehabilitation Act of 1973 or the Affordable Care Act. 

First, the Court observed that in Pennhurst State School and Hospital v. Halderman, 451 U.S. 1, 17 (1981)) it held that under the Spending Clause of the Constitution Congress has power to “fix the terms on which it shall disburse federal money.” 142 S. Ct. at 1569. Using that authority, Congress has enacted statutes prohibiting recipients of federal financial assistance from discriminating on the basis of certain protected characteristics, such as disabilities. At issue in Cummings were the Rehabilitation Act and Affordable Care Act. The Rehabilitation Act bars funding recipients from discriminating because of disability. 29 U.S.C. § 794. The Affordable Care Act outlaws discrimination because of race, color, national origin, sex, disability, or age, by healthcare entities receiving federal funds. 42 U.S.C. § 18116. See 142 S. Ct. at 1569.

The Court observed that in Barnes v. Gorman, 536 U.S. 181, 185 (2002) it held that these kinds of Spending Clause statutes can be enforced through implied rights of action. The Court noted in Barnes, however, that “it is less clear what remedies are available in such a suit.” 142 S. Ct. at 1569-70 (quoting Barnes, 536 U.S. at 185). 

The Court then observed that cases like Gebser v. Lago Vista Independent School Dist., 524 U.S. 274, 286 (1988) clarified that whether a particular remedy is recoverable must be informed by the way Spending Clause “statutes operate”: by “conditioning an offer of federal funding on a promise by the recipient not to discriminate, in what amounts essentially to a contract between the Government and the recipient of funds.” 142 S. Ct. at 1570 (quoting Gebser, 524 U.S. at 286).

The Court reasoned that because Spending Clause legislation operates based on consent, the legitimacy of Congress’ power to enact such laws rests on “whether the [recipient] voluntarily and knowingly accepts the terms of th[at] ‘contract.’ ” 142 S. Ct. at 1570 (quoting Barnes, 536 U.S. at 186 (quoting Pennhurst, 451 U.S. at 17)). The Court noted that it had applied this contract-law analogy to define the scope of conduct for which funding recipients may be held liable, with an eye toward ensuring that recipients had notice of their obligations. Thus, the Court concluded that a particular remedy is available in a private Spending Clause action “only if the funding recipient is on notice that, by accepting federal funding, it exposes itself to liability of that nature.” 142 S. Ct. at 1570 (quoting Barnes, 536 U.S. at 187).

The Court therefore framed the question in deciding whether emotional distress damages are available under the Spending Clause statutes in Cummings as whether a prospective funding recipient deciding whether to accept federal funds would have had “clear notice” regarding that liability. 142 S. Ct. at 1570-71 (quoting Arlington Central School Dist. Bd. of Ed. v. Murphy, 548 U.S. 291, 296 (2006)). 

The Court pointed out that because the statutes at issue were silent as to the available remedies, it was not obvious how to decide that question. It observed that in Barnes, which involved the question whether punitive damages are available under the same statutes, the Court followed the contract analogy and concluded that a federal funding recipient may be considered “on notice that it is subject … to those remedies traditionally available in suits for breach of contract.”  142 S. Ct. at 1570-71 (quoting Barnes, 536 U.S. at 187). Given that punitive damages “are generally not available for breach of contract,” Barnes concluded that funding recipients “have not, merely by accepting funds, implicitly consented to liability for punitive damages.” 142 S. Ct. at 1570-71 (quoting Barnes, 536 U.S. at 187-88).

The Court then emphasized that Barnes considered punitive damages generally unavailable for breach of contract even though such damages are not unheard of in contract cases. In fact, Barnes cited treatises that described punitive damages as recoverable in contract where “the conduct constituting the breach is also a tort for which punitive damages are recoverable.” Barnes, 536 U.S. at 187-88 (quoting Restatement (Second) of Contracts § 355, p. 154). The Court observed that this recognized exception to the general rule, however, was not enough to give funding recipients the requisite notice that they could face such damages. Under Barnes, the Court therefore presumed that recipients are aware that they may face the “usual” contract remedies in private suits brought to enforce their Spending Clause “contract” with the Federal Government.142 S. Ct. at 1571

Using this framework, the Court found the analysis in Cummings to be straightforward. Because emotional distress damages are generally not available for a breach of contract, the Court held that under Barnes, the Court could not treat federal funding recipients as having consented to be subject to damages for emotional distress. Therefore, the Court held that such damages are accordingly not recoverable under the statutes and facts at issue in Cummings.


In sum, Cummings held that emotional distress damages are not recoverable in private actions to enforce the antidiscrimination provisions of the Rehabilitation Act of 1973 or the Affordable Care Act. 

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