The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) allows states to provide optional Medicaid coverage to aliens not qualified but not expressly excluded under federal standards. Colorado originally maintained Medicaid coverage beyond the federal requirements as it had done before the enactment of PRWORA. However, in 2003 the state passed Colorado Senate Bill 03-176, which removed the optional Medicaid coverage in order to help reduce a budget shortfall. Soskin and a class of legal aliens (plaintiffs) facing termination of assistance sued the state of Colorado in federal district court to stop the law from taking effect. They claimed that the more burdensome eligibility requirements of the new bill unlawfully discriminated against legal aliens. The Court of Appeals for the Tenth Circuit reviewed the case on appeal.