400 Holding Health Insurance Marketplaces Accountable 2015
zations on the boundary between the state and the private sector.463
This article argued that the current law of § 1983 is too rigid to accommodate the new, complex, and divided authority of the Health Insurance
Marketplaces and will create an arbitrary gap between the availability of
private enforcement against Medicaid agencies and the availability of private enforcement against the Marketplaces.464 In the context of a complex
regime administered largely by a federal agency, courts should recognize
the more nuanced relationships that exist between federal agencies, state
officials, and beneficiaries by recognizing delegations of rights-making authority to agencies for the purposes of § 1983. Clinging to the rigid doctrine
of the status quo threatens the demise of private enforcement in our increasingly complex healthcare landscape.
463. See supra Part IV.
464. See supra Part IV.