On May 13, 2019, the United States District Court for the Northern District of California released this complaint for injunctive and declaratory relief filed by the plaintiffs of California v. Azar. The plaintiffs, the state of Washington, California, Massachusetts, Connecticut, and Oregon, take complaint against the United States Department of Health and Human Services (DHHS) final rule on Medicaid in May of 2018. The plaintiffs claim that the final rule violates the law and that Section (a)(32) of the Medicaid Act does not prohibit the voluntary deduction of union dues from personal care services provider paychecks . . .