Need b ve blood group

Mikhail Khodorkovsky, once his country’s richest man, has resided in “gulag lite,” as he calls the Russian penal system under Vladimir Putin, for six years. Since the spring, on most working days he is roused at 6:45 in the morning, surrounded by guards and packed into an armored van for the drive to court. For two hours each way, the man who once supplied 2 percent of the world’s oil crouches in a steel cage measuring 47 by 31 by 20 inches. Convicted of tax evasion and fraud in 2005, Khodorkovsky now faces a fresh set of charges that add up to the supposed theft of $30 billion. In the dark of the van, Khodorkovsky tries to prepare for his trial, replaying in his mind his night reading, the daily stack of documents from his lawyers. But Russia’s most famous prisoner worries too about what would happen if a car slammed into the van. (Collisions are routine in Moscow’s clotted avenues.) “Your chances of making it out alive,” he wrote me one day this summer, “at any speed, are next to none.”

Khodorkovsky (pronounced ko-door-KOFF-skee) has spent more than 2,200 days behind bars. He cannot receive reporters. Yet the ban has brought a revival of a dissident tradition dating back to Ivan Grozny and Prince Andrey Kurbsky in the 16th century: the epistolary exchange. For several months this year, from July until October, Khodorkovsky and I were able to conduct a series of exchanges — as he has done with other correspondents, both foreign and native — filtered through the hands of lawyers (who transcribe his oral replies) and avoiding the eyes of prison officials. In court, he has maintained that he fails to understand the case against him. The new indictment runs 3,487 pages but boils down to a single accusation: that the former C.E.O. of the Yukos oil firm and his deputy, Platon Lebedev, were part of an “organized criminal group” that stole 350 million tons of oil from their company between 1998 to 2003. The tonnage exceeds Yukos’s production during the period in question. If convicted, Khodorkovsky, whose first sentence ends in 2011, could face an additional 22 years in jail.

In the decade since Putin’s rise, Russians have grown inured to celebrity criminal cases. The murders of politicians, journalists and human rights activists; apartment-house blocks bombed to ruins; the carnage of the hostage sieges in Moscow and Beslan — the acts of horror and terror have numbed the populace. The exception is the delo Khodorkovskogo — the Khodorkovsky case. No other affair has lingered as long in the minds of so many. The case marked a turning point for Russia, the divide between the turbulent Yeltsin years and the stricter rule of the Putin era. And today, in its second iteration unfolding in Moscow, much more than the fate of an oligarch hangs in the balance.

From the start of his presidency on New Year’s Day 2000, Putin was on a roll. But it was the takedown of Khodorkovsky in 2003 that upped the ante. Under Yeltsin, the chieftains of Russia’s vast financial-investment groups held sway over the vital industries (oil, metals, banking and media) and, to a large degree, held the government hostage. That changed on a frigid October night, when masked agents of the Federal Security Service boarded a plane on a Siberian tarmac and enacted one of the most famous perp walks in Russian history, an oligarch returned to the capital at gunpoint.

Khodorkovsky’s arrest stunned Russian nationalists and Western hedge-fund managers alike. Putin had forced the oligarchs to toe a new party line: profits could be blessed, but only if politics stayed off-limits. “The Yukos case marked the start, in 2003, of gosudarstvennoe reiderstvo ” — “state raiding” — Khodorkovsky told me in a Russian-language reply last month. For edification, he explained ‘ ‘reiderstvo ,” a word borrowed from Wall Street that has entered the language of Pushkin: “That is, the seizure of others’ property with the aid of state institutions (first and foremost, the organs of law enforcement).” The attacks, he argued from jail, spelled “a disaster for Russian business.” Under Putin, the state blithely acquired a string of Russia’s fattest companies — first and foremost, Khodorkovsky’s own. Despite assurances that the Kremlin would never nationalize Yukos, the state oil company Rosneft, led by Igor Sechin, a Putin confidant and former intelligence officer, soon took over Yukos’s most prodigious fields and refineries.

For Putin, the reclamation project proved a boon. Russia’s titans locked arms in a docile chorus and rushed to finance Kremlin projects. For years, as long as the price of Urals crude soared, Putin could forget about an unruly oligarch in a Siberian prison. He could even decamp from the Kremlin, usher in a handpicked successor (Dmitri Medvedev), move to the prime minister’s office and remain the power behind the throne. But the second Khodorkovsky trial has come at an inopportune time. For a decade, Putinism rested on an unsound social contract, a sacrifice of liberties for stability. Now, however, the global downturn has hit. Russia’s economy is projected to contract by 8 percent in 2009, and the number of Russians below the poverty line has grown to 17 percent. At the same time, the Putin-Medvedev diarchy — diarkhiya , pundits term it — is showing its seams, and the campaign against Khodorkovsky, a cornerstone of Putin’s rule, threatens to open fissures. In Moscow, the circle of those who question the hard line has widened beyond marginalized liberals — to oligarchs, politicians, even journalists, who once marched in lock step with the Kremlin. Their voices are unlikely to spur a groundswell of support for Khodorkovsky, much less an organized political opposition. But they do pose a discomfiting question, one that has hung over the Kremlin since the legal campaign began: Who fears a free Khodorkovsky?

THE ANSWER MAY lie in the history. At 46, Mikhail Khodorkovsky has lived several lives. As a boy, he never wanted to be a cosmonaut or a general or a soccer star. He dreamed of becoming a factory boss. That his dream came true, in such stunning fashion, leads you to wonder whether his meteoric rise was a matter of genius, luck, ruthlessness or connections. To be sure, timing, intelligence and muscle all played a part. But the son of engineers had no running start.

Boris Khodorkovsky and his wife, Marina, gave decades to Moscow’s Kalibr plant, maker of high-precision instruments. Yet by 23, their son was an ascendant graduate of one of the U.S.S.R.’s most prestigious chemistry institutes, a state loyalist who had served as the deputy chairman of the institute’s Komsomol, the Communist Youth League. As he sought to take advantage of the improbable opportunities that arose under Mikhail Gorbachev, Khodorkovsky’s Komsomol tenure, a rarity for a Jew in Moscow, would open state doors. By 26, even before the fall of the Soviet Union, he had made his first fortune — importing PCs and selling them at a sixfold profit. Soon he had founded a bank, Menatep, one of the first private brands in Soviet finance.

In 1991, as he reminded me, Khodorkovsky left his wife at home with a rifle and stood inside the besieged White House, seat of the Russian government, as Yeltsin climbed atop a tank and sped the Soviet collapse. In 1995, at 32, Khodorkovsky, leading the savviest team in Moscow, had amassed enough money and contacts to take over Yukos, a state-owned petroleum behemoth, for a $309 million down payment. The following year, he helped stave off the Communists’ revanche and re-elect Yeltsin. By 40, Khodorkovsky reigned among the oligarchs, with a portfolio that had spread from banking to agriculture to oil. As Russia entered the new century, and Yukos rose as its most prodigious oil company, its C.E.O. became a multibillionaire.

Moscow would soon grow famous for operatic oligarchs and Byzantine intrigues, but Khodorkovsky never got caught in a compromising position — never snared at an Alpine resort, a Moscow casino or on a Riviera yacht. Girls, power, even the money, seemed to hold no magic. Where others basked in pomp, he was shy and painfully soft-spoken; you never heard his squeaky voice, a semitone deeper than Mike Tyson’s, at dacha parties for the foreign press, let alone on television. He divorced young but stayed on good terms with his first wife. Inna, his second, he met at the institute. Khodorkovsky was never flashy — he wore jeans and turtlenecks; the family vacationed in Finland — but he radiated the unlikely allure of a muscular technocrat. And yet, even at the top, he seemed adrift, unsure of his role in society. Unlike older Jewish oligarchs, men like Boris Berezovsky and Vladimir Gusinsky, who were often animated by old scores to settle, Khodorkovsky did not seem to consider himself an outsider. Lacking a public persona, he came to personify, by default, the revenge of the Soviet geek.

By 2000, Putin had entered the Kremlin. But Khodorkovsky — his net worth reportedly $2.5 billion — tried on a new role. He’d changed, he told colleagues. If in the past, Yukos and Menatep had exploited tax havens, stringing a daisy chain of shell companies across the offshore zones of Europe, Khodorkovsky now became an advocate for corporate governance. The first signs of an evolution had come under Yeltsin. In 1998, Russia suffered a crash — the state devalued the ruble, defaulted on $40 billion in bonds and cut its umbilical cord to the capital markets. Banks collapsed, the stock market tanked and the oligarchs turned desperate. Khodorkovsky, or so he told colleagues at the time, saw the need to reform. Companies that believed in transparency and shareholders’ rights, he now preached, did not fear lean times; they attracted foreign investment, and they grew. Skeptics abounded. It was, at the least, a timely conversion.

Even as Putin sought to curb the oligarchs, Khodorkovsky expanded his influence by new means. He brought in American firms like McKinsey and Schlumberger, experts in making the most of oil and profits. He also sought an insurance policy. Nearly a decade ago, he hired APCO, the Washington lobbying firm that employs former ambassadors and Congressmen. But in Putin’s second year in power, Khodorkovsky opened another front, setting up a foundation to support nonprofits and human rights groups. In the months before his arrest, he courted the administration of George W. Bush and power brokers like James Baker. His foundation recruited Henry Kissinger and Lord Rothschild for its board. He financed policy groups in D.C. and human rights activists at home, and to the joy of Laura Bush, he gave a million dollars to the Library of Congress. He joined the Carlyle Group’s Energy Advisory board, serving alongside Baker, and met — on separate occasions — with the elder Bush, Condoleezza Rice and Vice President Dick Cheney.

In Houston, Khodorkovsky dangled a 40 percent chunk of Yukos before the oilmen — the sale would have fetched billions and, possibly, ensured protection from the state. But in 2003, in a brazen affront, Khodorkovsky started to finance opposition political parties. Then that fall, he completed a megamerger, the union of Yukos and Sibneft, another Russian major, to create the world’s fourth-largest oil company. His rise was nearly complete. But all the while, as he told me in one exchange, he’d seen the warning signs. “I knew they’d arrest me,” he wrote. “I even spoke about it.”

In October 2003, Khodorkovsky boarded a jet in Moscow a near-wanted man. After a summer of saying goodbyes to friends and family abroad, he embarked on a farewell tour. It would be a second act in his new role, an audition in the hinterland. He went on the stump, lecturing on a newfound vocation: “Democracy.” To his surprise, the gamble proved a success — eight regions, dozens of appearances, mostly young people at every stop. He was even given the stage at a military college. Next up was a human rights forum in a Siberian city nearby. But before his plane could take off, the dark vans had formed a circle on the tarmac.

“WHO FEARS A FREE Khodorkovsky?” asked Marina Filippovna Khodorkovskaya, the defendant’s 75-year-old mother. “Forgive me if I’m blunt, but it’s Putin, and all those around him who stole Yukos.” Marina Filippovna comes to court as often as possible. A sturdy former engineer, she has never shied from speaking her mind. Asked by the BBC what she would do if she met Putin, Marina Filippovna replied without pause, “I would kill him.” “It’s not for me to say what led to all this,” she told me, as we stood together one morning, awaiting the arrival of her son, in the dilapidated Khamovnichesky District Court in central Moscow. She raised both hands to conjure the years of turmoil. “I only know this case is about politics and money. But which is more important, only those on high” — again she gestured, this time to the ceiling — “know the truth.”

The answer is unlikely to emerge in Judge Viktor Danilkin’s courtroom, a humble affair on the third floor of a squat building perched above the Moscow River. Each time I went to court, over the course of two weeks earlier this year, I sat a few feet from the defendant. It was a scene to boggle Kafka’s imagination.

Khodorkovsky would spend hours, pink highlighter in one hand, yellow Post-its in another, meticulously winnowing down a stack of papers balanced on his crossed legs. He sat on a bench, locked inside a narrow rectangle of steel and bulletproof glass, along with his former deputy Lebedev. “The aquarium,” the guards have nicknamed the new model of the Soviet-era defendants’ cage. The wall of glass alone, Khodorkovsky later said in a missive, weighs a ton and a half. Court officials asked the defense team, a roster as long and distinguished as any in the annals of Russian jurisprudence, to move their desks away from the cage. “They feared the floorboards would buckle,” Khodorkovsky explained.

The trial is open, but only three or four reporters (all local) show up regularly. One morning, Marina and her husband, Boris, sat in the front row. On another day, Garry Kasparov, the chess grandmaster turned opposition leader, anchored a row in back, his bodyguard nearby. Outside the courthouse, a car blasted Russian techno, and atop the steep riverbank nearby, lovers mingled on benches and a stray drunk slumbered. The audience, rarely more than two dozen, was dominated by a female crew of Khodorkovsky supporters — the most devoted was a schoolteacher on a daily vigil. One day the supporters passed out yellow and green scarves, the Yukos colors. Nearly everyone, including the journalists, tied them around their necks.

The trial, now in its ninth month, has been distinguished by a Stakhanovite act of labor: the reading, without pause for water or bathroom breaks, of the evidence — 188 volumes of documents collected from the defense or in wiretaps and raids on Yukos, Menatep and affiliated offices. Like the prosecutors’ uniforms and the absence of a stenographer, the recitation is a Soviet holdover. The defense team, five lawyers that day, half-hidden behind an array of vases filled with roses, have the documents scanned, summonable on laptops. Valery Lakhtin, the reedy prosecutor, not only has trouble carrying the volumes (each several fingers thick); at times he seems in danger of drowning in all the oil and high finance. When he stumbles, confusing tons and barrels, dollars and rubles, the judge gently intervenes.

The courtroom contains two worlds. Behind the glass, Khodorkovsky and Lebedev grimace, giggle and kibitz. The two men, ghostly pale from years in prison, are the most animated people in the room. The lawyers, prosecutors and audience regulars sit still, silent actors for the most part in a burlesque. Nearly everyone tunes out the prosecutor’s droning. The guards fend off sleep, a courtroom artist sketches the roses and most heads turn to reading material.

I sat beside a security officer in plain clothes, a higher-up. For hours, he studied his cellphone, clicking through a novel. The reporters double-tasked between laptops — in a first, courtroom blogging is allowed — and books. One read Chuck Palahniuk. Two girls in their 20s read the Gospels. A man in back listened to an iPod. A teenager nearby did Sudoku. “It all seems pleasant,” Khodorkovsky’s chief Russian lawyer in the West, Karinna Moskalenko, had warned. Moskalenko, Russia’s most prominent human rights lawyer, has been on the legal team since shortly after the arrest. “The judge is polite; the clerk is attentive. My client can speak his mind, and we are treated kindly. But that’s all it is — a show, a farce.”

“Ours,” as his lawyers call Khodorkovsky, does not waste his days in court. He sifts through the papers and at times slowly stands, taps a microphone in the aquarium and pulls the brake on the prosecutor. He does not speak often, but when he does, it is with puckish brevity. Even after so long behind bars, Khodorkovsky remains the chief executive, amused by his surroundings, tolerant of the inconvenience and utterly undeterred.

Prison has changed him, to be sure. His hair is buzzed to a gray stubble, and his eyes are lined with red, but the rimless glasses, more befitting a Scandinavian scientist, remain. He is a man, even after years of a prison diet, of considerable bulk, but the unlikely softness of his features stands out, the tapered fingers and thin lips that can form a sudden, inscrutable smile. His confinement, it occurs to me as I watch him day after day, amounts to a third act in a singular evolution. Some may have doubted the authenticity of Khodorkovsky’s conversion to corporate governance or Jeffersonian democracy. But in court, it is not hard to see how his supporters believe that in prison he has gained what he lacked as an oligarch: an aura of moral fortitude.

Khodorkovsky insists his compatriots are watching. “The Yukos case,” he writes, “is known to every Russian entrepreneur, every judge and prosecutor, as well as the majority of the state’s officials and policemen.” He adds: “Thanks to its widespread publicity, the case will set the standard for investigation, court proceedings and respect for human rights on the part of the bureaucracy. It demonstrates what the state can and can’t do in order to meet its goals.”

The treatment, even by Russian standards, has been harsh. Khodorkovsky has spent 39 days in solitary, and 26 on hunger strikes. His health deteriorated. Moskalenko sought the advice of a London toxicologist — delivering his fingernail clippings from the camp in Siberia where he was being held — fearful her client had been poisoned. He did have his nose slashed — by a cellmate who claimed self-defense in a homosexual approach. (Khodorkovsky’s lawyers had long feared a jailhouse attack, but dismissed the incident. “Pathetic provocation,” one termed it.) Khodorkovsky has earned time in solitary for an array of offenses: accepting two lemons from his wife, sipping tea in an improper site, leaving his workstation (his camp job was to sew shirts and gloves), possessing state decrees on prison regulations and failing to walk with his hands behind his back outside his cell. He has spent more than two years in fetid Moscow remand jails. He now shares a cell with between 3 and 8 prisoners; for nearly two years after his arrest, he shared, with as many as 15 others, a cell equipped with iron bunks, a single table and a 33-inch partition to shield a common toilet.

From the beginning, however, an issue has hampered the defense: Khodorkovsky is no classic dissident like Sakharov. As Khodorkovsky built Yukos, the oligarchic standards of the 1990s were maintained: the state bureaucracy and offshore zones were exploited. And in the tumult, as Putin noted recently, there was blood. In 1998, on Khodorkovsky’s birthday, Vladimir Petukhov, the mayor of Nefteyugansk, a Siberian town fed on Yukos oil, who had complained about Yukos’s failure to pay its debts to the town and its workers, was shot dead. Then there was the 2002 disappearance of Sergei Gorin, onetime manager of the Tambov branch of Menatep, and his wife, Olga. To date, their bodies have not been found, but a Moscow court has convicted one of Khodorkovsky’s closest former partners, Leonid Nevzlin, now living in Israel, of ordering their murder. Khodorkovsky, Nevzlin and their lawyers deny any involvement in the crimes.

Khodorkovsky’s arrest divided the human rights community. Many can’t quite embrace an oligarch as a prisoner of conscience. He is a titan who fell from favor, some say, not a dissident physicist or a novelist arrested for a subversive manuscript. Whatever his sins, though, Khodorkovsky was not jailed for breaking the law. His courting of the Bush White House and pursuit of oil partners at home and abroad infuriated the Kremlin. But his gravest error was to challenge Putin. The reason behind his imprisonment, Khodorkovsky claims, “is well known and widely discussed. It was my constant support of opposition parties and the Kremlin’s desire to deprive them of an independent source of financing. As for the more base reason, it was the desire to seize someone else’s efficient company.”

His motives may have been mercenary, but Khodorkovsky in his cell has come to embody the fiat of the state, its arbitrary and boundless power. To date, the authorities have brought charges against 43 former Yukos employees and associates, conducted more than 100 raids (including one on the orphanage run by Khodorkovsky’s parents) and jailed a string of defense lawyers. Two suffered particularly ugly ordeals. Vasily Aleksanyan, a 38-year-old Russian with a Harvard law degree, remained behind bars for more than two years, although ill with AIDS and cancer. Svetlana Bakhmina, a Yukos lawyer with two small children, was jailed for four and a half years. Last year she gave birth to a daughter in a prison hospital and was released in April only after an international outcry.

DELIVERANCE, Khodorkovsky and his legal team believe, might lie in the West. In the aftermath of Khodorkovsky’s arrest, President Bush fell silent, and many old friends ran for cover, but in 2005, Senator Barack Obama co-sponsored, with John McCain and Joe Biden, Senate Resolution 322. The move was symbolic but caught the attention of many in Moscow, declaring that “it is the sense of the Senate that the criminal-justice system in Russia has not accorded” Khodorkovsky and Lebedev “fair, transparent and impartial treatment.” After Obama’s inauguration, as the new president pledged to hit the “reset button” on U.S.-Russia relations, the oligarch’s lawyers and lobbyists waited nervously. In July, on the eve of his first Moscow summit, President Obama offered a surprise.

“It does seem odd to me,” Obama told Novaya Gazeta, the last genuine newspaper in Russia, “that these new charges, which appear to be a repackaging of the old charges, should be surfacing now, years after these two individuals have been in prison and as they become eligible for parole.” The president cushioned it — “I would just affirm my support for President Medvedev’s courageous initiative to strengthen the rule of law in Russia.” But to Russian ears, Obama’s statement resounded like a slap in Putin’s face.

With or without the White House, Khodor­kovsky’s counterassault continues apace. At present, cases relating to his arrest and the takeover of Yukos have been heard, or will be soon, in a half-dozen European venues. Khodorkovsky looks forward, above all, to the battle at the European Court of Human Rights in Strasbourg. The court is expected to hear the first of three cases Moskalenko has filed on his behalf, concerning his arrest and pretrial detention. The Kremlin faces another challenge in Strasbourg: a case brought by the American “management in exile” of Yukos, a claim said to be as high as $100 billion.

Still, Khodorkovsky has few illusions about the West. “Without a doubt,” he said of former supporters abroad, “they were only doing what they considered useful for their own country.”

“I’VE NEVER BEEN a corrupt state official, nor an autocrat,” Khodorkovsky wrote to me. He was subtly nodding to the duo often accused in Moscow, at times in public forums, of standing behind the Yukos case: Putin and Sechin, the Rosneft chairman who now controls Yukos’s assets. Khodorkovsky has, however, been careful to praise Putin’s heir. “I respect Dmitri Medvedev as the legitimate president of Russia,” he told the newspaper Sobesednik in March. “However, his political views are not fully clear to me. Yukos he certainly didn’t rob — and he has nothing to fear from me or Platon Lebedev. ”

If Medvedev has no reason to fear Khodor­kovsky, he could be the man to free him, or so holds a new school of thought. Among the last of Moscow’s incorrigible liberals, it has become fashionable to speak of the trial as an “opportunity”: a chance for Medvedev to rid himself of an inherited albatross and prove he is his own man. Early in his tenure, Medvedev swore to combat Russia’s “legal nihilism” — a euphemism for judicial corruption. The new president is also tech-savvy — he sports an iPhone and a video blog. If Yeltsin lived in a bubble and Putin was tethered to a self-serving intelligence network, Medvedev can Web-surf and see how the world sees Russia. The “new cold war,” the murders of human rights activists, investigative reporters and liberal politicians, and the rumors of arms shipments to Iran — he knows the news is bad. So great is the hope that Medvedev is a liberal waiting for his moment, and the lack of faith in a just trial, that Russian commentators have raised the unlikely idea of a pardon.

In July, Medvedev laid out the terms. “The procedure has to be carried out in accordance with our country’s rules,” the president told Italian reporters. “In other words, a person must appeal to the president, plead guilty to having committed a crime and seek the appropriate resolution. So at this point,” he added coyly, “there’s nothing to discuss.” The half-denials, coming in rapid succession, have only fueled the speculation. Back in 2002 and 2003, as the battle turned to war and executives became prisoners, Khodorkovsky counted Medvedev, who became Putin’s chief of staff days after his arrest, on his side. That perception, however wishful, may explain his willingness to suspend disbelief and, as he told me, “support Medvedev’s efforts” by not defending himself in overtly political terms in court.

His lawyer Moskalenko, however, does not await an awakening. “Even if Medvedev signed a pardon,” she says, “I have strong doubts this piece of paper would get beyond the walls of the Kremlin.” Experience underlies the statement. Medvedev is said to have signed such a pardon last year, for the then-pregnant Bakhmina. It never reached her lawyers. As for the prisoner himself? “No one, except two people in the country, know how long I’ve got until my release — or if it will ever come.”

He once had a choice, the lawyers say with reluctance. Not long after the arrest, a deal was on Putin’s desk: exile or jail. In time, many would flee, from Khodorkovsky’s closest partners to accountants whose faces he would not know. They live in restless exile, in England, Greece, Israel, Spain and the United States. Khodor­kovsky holds no enmity for those who fled — “Why breed hostages?” he says. But for him, the door was not open. “I’d rather be a political prisoner,” he told Moskalenko, “than a political refugee.”

The trial continues, now with a parade of witnesses. Khodorkovsky, who once boasted that his empire had adopted “paperless technology,” has reading material to outlast the year. But he looks, more and more, to that distant horizon. He’d like to return to the energy sector, he says. Not oil this time, but “solar,” a subject from his institute days. He could also lend a hand, he says, in raising Russia from the recession. After all, he has proved himself to be a “good crisis manager.”

One morning in June, a day before the defendant’s 46th birthday, a pair from Washington remained in court at the end of the day’s session. Margery Kraus, head of APCO, the D.C. lobbying firm, clasped her hands overhead. A victory salute. Eugene Lawson, former head of the U.S.-Russia Business Council, a group that aimed to unite mistrustful C.E.O.’s in a mutually enriching embrace, repeated the gesture. With his silvery hair and dark pinstripes, Lawson looked every bit the patrician guest from the West. In 2007, Putin awarded him the Order of Friendship. Last year, Lawson was named to APCO’s international advisory council. He faced the glass, raised a hand, fingers flat, to cut through the air at an angle — an airplane zooming into flight. We’re heading home, the American hands said, but we stand behind you.

The courtroom guards closed ranks, unlocked the cage and handcuffed Khodorkovsky and Lebedev, each to a guard. On the stairwell outside, the crowd, mostly women, young and old, called out — they wished him well on his birthday. The man who many still believe remains a billionaire wore slippers, thin trousers, a suede coat and a sleeveless shirt buttoned to the top — all well-worn. We came within inches of each other. In one hand he carried a string bag, filled with his notes and a plastic bottle nearly empty of water. He passed by in silence, lips pursed in a half-grin, up the stairs, and in a moment, amid the thud of boots on cement, the world’s most problematic political prisoner was gone.

In April, Nancy Niemi entered Vidant Medical Center in Greenville, N.C., with cardiac problems. She stayed four nights, at one point receiving a coronary stent.

Then she went home, but felt faint and took several falls. Five days later, her primary care doctor sent her back to the hospital. This time, her stay lasted 39 days while physicians tried various medications to regulate her blood pressure.

Though they eventually succeeded, Mrs. Niemi, 84, a retired insurance agent, had grown so weak that she could no longer walk.

“They said, ‘She really needs to go to a skilled nursing facility for physical therapy,’” recalled her son Tom Krpata, 63, who’d come from his home in Holliston, Mass., to be with her.

He agreed, but soon learned one of the brutal truths of Medicare policy: Patients can be hospitalized for days, can undergo exams and tests, can receive drugs — without ever officially being admitted to the hospital.

Instead, they’re “under observation,” which means they’re outpatients, not inpatients . That can bring financial hardships — including lack of coverage for subsequent nursing home care.

That’s why Mrs. Niemi, on observation status through both hospital stays except for one night, had to pay for rehab herself. “By declaring her an outpatient, they really took away her Medicare benefits,” Mr. Krpata said.

Patients can appeal virtually any other claim that Medicare denies. But there’s no way to appeal observation status. Even Mrs. Niemi’s congressman, contacted by her family, couldn’t help.

But a recent ruling in a case that’s bounced through the courts since 2011 may be a harbinger of changes to come.

On July 31, a federal judge in Connecticut certified a class in a class-action lawsuit: all Medicare recipients who’ve been hospitalized and received observation services as outpatients since January 1, 2009.

That means hundreds of thousands of people, Ms. Niemi among them, will be eligible to join the suit against the Centers for Medicare and Medicaid Services, with a trial expected next year. If the plaintiffs prevail, they’ll be able to appeal their observation-outpatient stays.

“People call in dire situations, and we have to tell them there’s no way to challenge this,” said Alice Bers, litigation director of the Center for Medicare Advocacy, which brought the lawsuit with Justice in Aging and a law firm, Wilson Sonsini Goodrich & Rosati. “Now we can tell them, ‘You’re a member of the class, so stay tuned.’”

A quick primer on a confusing situation: Medicare Part A covers hospital care for inpatients. Outpatients, including those on observation status, are covered under Part B. That distinction has generated complaints and controversy for years, as the number of inpatient hospitalizations has declined among Medicare recipients and outpatient stays have become more common .

Why does the classification matter? Outpatients can face higher payments for drugs and coinsurance, but the big-ticket item is nursing home care .

After a hospital discharge, Medicare pays the full cost of skilled nursing for the first 20 days, and most costs up to 100 days — but only for patients who’ve spent three consecutive days as inpatients. Without three inpatient days, patients are on their own.

Though most observation patients return home and needn’t to worry about nursing home costs, nearly two-thirds of those who do need skilled nursing have to shoulder the substantial costs themselves, according to a report from the AARP Public Policy Institute.

They hadn’t met the three-day inpatient requirement. Many, fearing the costs, skipped rehab in a nursing facility altogether , the researchers found.

Mrs. Niemi did go to a nursing home and now owes close to $5,000 — only because nursing homes near Greenville charge a comparatively modest $150 to $160 a day. Nationally, nursing home care cost $225 a day last year, according to the Genworth Cost of Care Study, and more than $400 a day in cities like New York and San Francisco.

Recognizing the problem, Congress passed legislation that took effect earlier this year, requiring that hospitals inform patients when they’re not inpatients but are under observation.

So while it came as news to Mr. Krpata that his mother’s status would mean no coverage for a nursing home, at least he knew what her status was — not that he could do anything about it.

Medicare administrators, who declined to comment for this article because of the ongoing litigation, tried to clarify observation status in 2013 with the so-called “two midnight rule.” When physicians expect a hospitalized patient to need care for at least two midnights, Medicare expects that inpatient care is probably appropriate; for shorter stays, beneficiaries would likely remain outpatients.

The rule hasn’t helped , though, according to a report last year from the Office of Inspector General of the Department of Health and Human Services. Inpatient stays are still decreasing and outpatient stays are growing, the report found. More of those outpatients have “limited access” to skilled nursing afterward, and pay more for it.

Gaining the right to appeal observation-outpatient classification won’t solve that problem, even if patients should win their class action suit.

“The Medicare appeals system is far from perfect,” said Ms. Bers. Patients routinely lose in the early stages, and though their odds of success improve if they pursue the appeal to an administrative law judge, many drop out before that point.

A far more effective remedy: the Improving Access to Medicare Coverage Act that Rep. Joe Courtney, Democrat of Connecticut, has introduced in each Congress since 2010. It calls for counting any consecutive three days spent in a hospital toward the requirement for nursing home benefits, regardless of whether people are inpatients or outpatients.

Not only has the bill drawn broad bipartisan support in both the House and Senate , a raft of medical and advocacy groups also have also endorsed it, including the American Medical Association and AARP.

“Going to a nursing facility is not on everybody’s wish list,” said Carol Levine, director of the United Hospital Fund’s Families and Health Care Project, who said she was not speaking for the group.

“But if it’s the best alternative for the patient, they shouldn’t have to jump over these kinds of bureaucratic rules that make it financially impossible.”

So far, though, the legislation has gone nowhere. For now, suing Medicare for the right to appeal probably offers the best route to fairer treatment for hospitalized patients.

“That’s the way these things move, in incremental steps,” Ms. Levine said. “And this could be an important one.”