The recent U.S. Supreme Court decision of Cummings v. Premier Rehab Keller, 142 S.Ct. 1562 (2022), resolved a split among the circuits, on the issue of whether emotional distress damages are available in a private action to enforce federal Spending Clause antidiscrimination statutes. The court, divided 6-3 along conservative/liberal lines, held that such damages are not recoverable under such legislation, particularly the Rehabilitation Act of 1973, which authorizes federal grants to states for vocational rehabilitation services, or under the Patient Protection and Affordable Care Act (ACA), which authorizes the distribution of federal monies to health-care entities.

In October 2016, Jane Cummings, a deaf and legally blind individual who communicates primarily using American Sign Language, sought physical therapy services from respondent, Premier Rehab Keller, a small business located near Dallas, Texas, that receives federal financial assistance pursuant to the Rehabilitation Act and the ACA. Cummings requested that Premier Rehab Keller provide her with an ASL interpreter at her appointments. Premier Rehab Keller declined, advising Cummings that she could communicate with the therapist using written notes, lip reading or gesturing. Cummings declined the suggestion and chose to obtain care from another provider.