Cummings v. Premier Rehab Keller, P.L.L.C.
Whether emotional distress damages are recoverable in private actions brought under federal anti-discrimination statutes enacted pursuant to Congress's Spending Clause power, specifically the Rehabilitation Act of 1973 and the Patient Protection and Affordable Care Act.
The Decision
6-3 decision · Opinion by John G. Roberts Jr. · 2022
Majority Opinion— John G. Roberts Jr.concurring ↓dissent ↓
The Supreme Court ruled 6–3 in favor of Premier Rehab Keller, holding that emotional distress damages are not recoverable in private actions brought under the Rehabilitation Act, the Affordable Care Act, or other federal anti-discrimination statutes enacted under Congress's Spending Clause power. The majority opinion was written by Chief Justice John G. Roberts Jr.
The majority's reasoning rested on the well-established principle that Spending Clause legislation operates much like a contract. When Congress attaches anti-discrimination conditions to federal funding, it is essentially making an offer: if you want the money, you must agree to these terms. Entities that accept the funds are voluntarily agreeing to comply. Because this relationship is contractual in nature, the Court held that the remedies available to private plaintiffs suing under these statutes must be limited to those traditionally available for breach of contract. This framework was established in prior cases and had already been used to exclude punitive damages from these statutes.
Applying this framework, the majority found that emotional distress damages are generally not available in breach-of-contract suits under traditional contract law. While acknowledging that some narrow exceptions exist — for instance, in cases involving contracts where serious emotional disturbance was a particularly likely result of a breach — the Court concluded that these exceptions were too limited and inconsistent to establish emotional distress damages as a generally accepted contract remedy. The majority emphasized that the relevant question is what a reasonable funding recipient would understand its obligations to be upon accepting federal funds, and no reasonable entity would have understood it was agreeing to emotional distress liability given the general unavailability of such damages in contract law.
The Court rejected Cummings's argument that anti-discrimination statutes should be treated as analogous to the specific types of contracts where emotional distress damages have traditionally been permitted. The majority acknowledged the practical consequences of its ruling — that some victims of discrimination might be left without a meaningful remedy — but stated that it was Congress's role, not the Court's, to expand the remedies available under these statutes if it so chose. The Court affirmed the Fifth Circuit's decision.
Concurring Opinions
Justice Brett Kavanaugh wrote a concurring opinion acknowledging the difficult situation facing discrimination victims who cannot recover emotional distress damages, and expressly invited Congress to authorize such damages if it wished to do so. Justice Neil Gorsuch also wrote a brief concurrence emphasizing the importance of hewing closely to the contract-law analogy in Spending Clause cases.
Dissenting Opinions
Stephen G. Breyerjoined by Sonia Sotomayor, Elena Kagan
Justice Breyer argued that the majority applied the contract analogy too rigidly and ignored well-established exceptions within contract law itself. He contended that emotional distress damages have long been recognized as appropriate in breach-of-contract cases where the contract's subject matter is personal or where emotional harm is especially foreseeable — conditions that are clearly met when the 'contract' involves promises not to discriminate against people on the basis of race, sex, or disability.
- Contract law has long recognized emotional distress damages in cases involving personal matters, dignity interests, and situations where emotional harm is the foreseeable consequence of breach — anti-discrimination provisions are a textbook example of such contracts.
- The majority's ruling leaves many victims of discrimination by federally funded entities with no practical remedy at all, because emotional harm is often the primary injury from discrimination and economic losses may be nonexistent or impossible to quantify.
- Funding recipients are clearly on notice that discrimination causes emotional harm, so they could reasonably anticipate liability for emotional distress damages when they voluntarily accept federal funds conditioned on non-discrimination requirements.
- The majority selectively applied the contract analogy by emphasizing the general rule against emotional distress damages while ignoring the well-documented exceptions that directly apply to the type of obligations at issue in these statutes.
Background & Facts
Jane Cummings is deaf and legally blind. She communicates primarily through American Sign Language (ASL). When she sought physical therapy services from Premier Rehab Keller, P.L.L.C., a provider located in Keller, Texas, she asked the clinic to provide an ASL interpreter for her appointments. Premier Rehab refused, instead suggesting alternative methods of communication such as written notes, lip reading, or having her husband interpret. Cummings viewed this refusal as disability discrimination and filed a lawsuit.
Cummings brought claims under several federal anti-discrimination laws, including Section 504 of the Rehabilitation Act of 1973 and Section 1557 of the Affordable Care Act (ACA). These statutes prohibit discrimination by entities that receive federal funding. Premier Rehab, as a healthcare provider that accepted federal funds (such as Medicare or Medicaid payments), was covered by these laws. The critical wrinkle was that Cummings could not show traditional economic harm like lost wages or medical costs resulting from the alleged discrimination. Instead, she sought damages for the emotional distress — the humiliation, frustration, and emotional harm — she suffered from being turned away.
The U.S. District Court for the Northern District of Texas dismissed her claim for emotional distress damages, ruling that such damages were not available under these statutes. The Fifth Circuit Court of Appeals affirmed, agreeing that the contract-law framework governing Spending Clause statutes did not support awarding emotional distress damages. This created an important split among the federal circuit courts of appeals. Some circuits, such as the First and Seventh Circuits, had permitted emotional distress damages under these statutes, while others, including the Fifth Circuit, had not.
The Supreme Court agreed to hear the case to resolve this disagreement among the lower courts. The question had significant practical consequences: for many victims of discrimination by federally funded entities, emotional distress may be the primary or even the only form of harm they suffer. If such damages were unavailable, these plaintiffs might have no meaningful remedy at all, which raised questions about the effectiveness of federal civil rights protections.
The case was argued on November 30, 2021, and decided on April 28, 2022.
The Arguments
Cummings argued that emotional distress damages should be available under the Rehabilitation Act and the ACA because these laws were designed to protect people from discrimination, and emotional harm is the most foreseeable and common type of injury that results from discriminatory treatment. She contended that the contract-law analogy the Court uses for Spending Clause statutes actually supports her position, because contract law has historically allowed emotional distress damages in certain categories of cases.
- Contract law has long recognized emotional distress damages in cases involving contracts that are deeply personal in nature — such as contracts related to healthcare, personal services, and matters of dignity — and anti-discrimination provisions fall squarely within this category.
- Funding recipients who accept federal dollars should reasonably expect liability for emotional distress damages because discrimination inherently causes emotional harm, making such damages the most foreseeable consequence of violating the anti-discrimination conditions attached to federal funds.
- Denying emotional distress damages would leave many discrimination victims with no remedy at all, since they often cannot point to quantifiable economic losses, effectively rendering these important civil rights statutes toothless in many cases.
Premier Rehab argued that emotional distress damages are not available under Spending Clause anti-discrimination statutes because these statutes function like contracts between the federal government and funding recipients, and emotional distress damages are not a traditional remedy in ordinary breach-of-contract litigation. A funding recipient could not reasonably have anticipated this form of liability when it accepted federal funds.
- Under the Supreme Court's longstanding Spending Clause framework, the remedies available to plaintiffs are limited to those traditionally available in breach-of-contract suits, and the general rule in contract law is that emotional distress damages are not recoverable.
- The Court's prior decision in Barnes v. Gorman (2002) already excluded punitive damages from Spending Clause statutes using the same contract-law analogy, and the same reasoning logically extends to emotional distress damages, which are similarly disfavored in contract law.
- Funding recipients must have clear notice of the conditions and potential liabilities they are accepting when they take federal money, and allowing emotional distress damages — which were not part of the traditional contract remedy toolkit — would violate this notice requirement.