Despite strong pushback from disability advocates, a case that could severely restrict the rights of those who rely on Medicaid and other government programs is set to go before the U.S. Supreme Court this week.

The high court is expected to hear arguments Tuesday in the matter known as Health and Hospital Corporation of Marion County v. Talevski.

The case hinges on whether individuals receiving services through programs like Medicaid have the right to sue state and local governments if their civil rights are violated.

Advocates say the implications could be far reaching affecting millions of beneficiaries of programs ranging from Medicaid to the Supplemental Nutrition Assistance Program, the Children’s Health Insurance Program, Temporary Assistance to Needy Families and more.

“An expansive ruling could prohibit individuals from seeking relief for violations of key civil rights statutes that prohibit discrimination in a wide variety of public programs,” said Shira Wakschlag, senior director of legal advocacy and general counsel at The Arc of the United States. “It’s the single greatest threat to the decades-long fight for health care access, community integration and civil rights for people with disabilities.”

The case brought by the family of Gorgi Talevski, who is now deceased, alleges that he was chemically restrained and medicated so that he would go to sleep instead of being treated for his dementia while living in an Indiana nursing home. Talevski’s estate sued under the Federal Nursing Home Reform Act and a lower court sided with them, but the nursing home’s owner, Health and Hospital Corporation of Marion County, or HHC, appealed to the Supreme Court arguing that nursing home residents shouldn’t be able to sue in federal court.

Disability advocates have been pushing back for months, lobbying HHC and elected officials in Marion County, Ind. — who appoint members to HHC’s board — to withdraw the matter. They say that the Supreme Court has recognized the ability of beneficiaries to sue if their rights under various safety net programs are violated by state or local governments for decades and that a win by HHC would leave virtually no recourse in such circumstances.

So far, the efforts seem to have gone unheeded.

“There have been peaceful demonstrations, press conferences and op-eds. Many people showed up to each HHC meeting in-person and gave public comment asking them to withdraw. At the last meeting, on top of thousands of emails sent to them directly and just under 20,000 signatures on our petition asking them to withdraw, the HHC board members chose silence instead of action,” said Jalyn Radziminski at the Bazelon Center for Mental Health Law. “It’s upsetting that our community has gone above and beyond to civically engage and advocate, while they have done nothing in their power to stop this.”

The case has drawn wide interest with over 20 amicus briefs supporting the Talevski estate from the Bazelon Center, The Arc, the American Association of People with Disabilities, AARP, top Democrats in Congress and more. Amicus briefs siding with HHC have been filed by a long-term care industry group as well as Indiana and 16 other states.

Radziminski said advocates remain optimistic that HHC will withdraw the case, which is still possible even after the Supreme Court hearing.