VIRGINIA M. HERNANDEZ COVINGTON, District Judge.
This matter comes before the Court upon consideration of Defendant Blue Cross and Blue Shield of Florida, Inc.'s Motion to Dismiss the Amended Complaint, or in the Alternative, Strike Prayer for Attorney's Fees in Counts I and II (Doc. # 16), filed on December 20, 2018. Plaintiff Heather Rosenberg responded on January 21, 2019. (Doc. # 32). Blue Cross replied on January 30, 2019. (Doc. # 36). For the reasons that follow, the Motion is granted.
"Since January 1, 2017, Rosenberg had a Florida Blue Affordable Care Act Qualified Policy which was on automatic renewal as well as automatic payment of insurance premiums." (Doc. # 8 at 2). Then, in November of 2017, Rosenberg obtained a new Blue Cross policy for herself and four family members. (
Time went on and Rosenberg never received notification that her policy had been terminated or cancelled. (
Rosenberg alleges that, because of Blue Cross's "unreasonable and unlawful termination/cancellation of coverage, [she] has been subjected to immediate and irreparable harm including but not limited to loss of insurance coverage for potential illness which has forced the purchase of a short term healthcare policy which does not provide adequate or equal coverage, has incurred out of pocket healthcare expenses and tax penalties caused by the wrongful termination of a Patient Protection and Affordable Care Act Qualified Insurance Policy." (
Rosenberg initiated this action on behalf of herself and all other similarly situated individuals on October 29, 2018. (Doc. # 1). Then, on November 15, 2018, Rosenberg filed the Amended Complaint, asserting the following claims: (I) for violation of 42 U.S.C. §§ 300gg-2, 300gg-12, and 300gg-42, which are sections of the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA); (II) for declaratory judgment pursuant to 28 U.S.C. §§ 2201 and 2202; (III) violation of the Florida Deceptive and Unfair Trade Practices Act (FDUTPA), Fla. Stat. §§ 501.201
Blue Cross now moves to dismiss all the claims of the Amended Complaint, or alternatively strike the prayer for attorney's fees in Counts I and II. (Doc. # 16). Rosenberg has responded (Doc. # 32), and Blue Cross has replied. (Doc. # 36). The Motion is ripe for review.
On a motion to dismiss pursuant to Rule 12(b)(6), this Court accepts as true all the allegations in the complaint and construes them in the light most favorable to the plaintiff.
Blue Cross makes numerous arguments for dismissal of the various counts of the Amended Complaint. The Court will address them one-by-one.
In Count I, Rosenberg asserts claims under two subsections of the ACA, 42 U.S.C. §§ 300gg-2 and 300gg-12. (Doc. # 8 at 12-13). Blue Cross argues these claims must be dismissed with prejudice because Sections 300gg-2 and 300gg-12 do not create private rights of action. (Doc. # 16 at 5-7).
Section 300gg-2 provides that a health insurer "must renew or continue in force [health insurance] coverage at the option of the plan sponsor or the individual" unless one of the exceptions listed in Section 300gg-2(b) applies. 42 U.S.C. § 300gg-2. These exceptions include that the insured individual "has failed to pay premiums or contributions in accordance with the terms of the health insurance coverage or the issuer has not received timely premium payments."
Blue Cross is correct that neither section explicitly creates a private right of action for insureds like Rosenberg. Rather, under Section 300gg-22, the Secretary of Health and Human Services or the appropriate state authorities are empowered to enforce the provisions of the ACA. 42 U.S.C. § 300gg-22.
Although there is no express private right of action, an implied private right of action still may exist. "[T]he burden rests with [Rosenberg] to establish that an implied private right of action exists."
"[T]he critical focus of the inquiry is the second Cort factor, and whether Congress intended to create a private right of action."
In her response, Rosenberg asserts that she "has an implied private right of action under the ACA due to the tax penalty and taxation falling outside the scope of the business of insurance pursuant to the McCarran Ferguson Act." (Doc. # 32 at 6). Rosenberg emphasizes that, at the time of her policy's cancellation, a tax penalty existed for individuals who failed to obtain insurance policies. (
According to Rosenberg, Section 300gg-12 "creates a private remedy by virtue of 26 U.S.C. [§§] 5000A(a) and 5000A(b)," which are sections of the Internal Revenue Code, because the "Internal Revenue Code provides a private right to action in the United States District Court." (Doc. # 32 at 7). So, Rosenberg reasons, an implied right of action under Sections 300gg-2 and 300gg-12 of the ACA exists because Blue Cross's alleged violation of these sections resulted in Rosenberg paying a tax penalty, which is governed by a different federal statute.
The Court is not persuaded by this argument. As Blue Cross correctly notes, the Amended Complaint "does not allege that [Blue Cross] violated 26 U.S.C. § 5000A" — it "challenges termination of her HMO Contract, not the federal government's imposition of the tax penalty." (Doc. # 36 at 3). Regardless, Section 5000A does not create a private right of action for individuals like Rosenberg and does not reflect an intent by Congress to create an implied right of action. (
Rather, the Court agrees with Blue Cross that an implied private right of action should not be read into Sections 300gg-2 and 300gg-12.
Also in Count I, Rosenberg asserts a claim under 42 U.S.C. § 300gg-42 in HIPAA. (Doc. # 8 at 12-13). Again, Blue Cross contends the claim must be dismissed because Section 300gg-42 does not create a private right of action. (Doc. # 16 at 7-8).
Section 300gg-42(a) provides that "a health insurance issuer that provides individual health insurance coverage to an individual shall renew or continue in force such coverage at the option of the individual" except for the reasons listed in Section 300gg-42(b). 42 U.S.C. § 300gg-42. These include that "[t]he individual has failed to pay premiums or contributions in accordance with the terms of the health insurance coverage or the issuer has not received timely premium payments."
This section does not create an express private right of action. And Blue Cross is correct that multiple courts have held that there is no private right of action — express or implied — under Section 300gg-42.
The Court notes that Rosenberg failed to address Blue Cross's arguments concerning HIPAA and Section 300gg-42 in her response. (Doc. # 32). Thus, it appears that Rosenberg does not oppose Blue Cross's request for dismissal of Count I to the extent it is brought under HIPAA.
And, upon review, the Court agrees with Blue Cross. There is no indication of congressional intent to create a private right of action for insureds like Rosenberg under Section 300gg-42. Count I is dismissed with prejudice because Section 300gg-42 does not create a private right of action.
In Count VI, Rosenberg asserts that Blue Cross violated the FTCA, 15 U.S.C. § 45. (Doc. # 8 at 18). Blue Cross again points out that there is no private right of action under this federal statute. (Doc. # 16 at 4). And Rosenberg has failed to respond to this argument. (Doc. # 32).
Blue Cross is correct. "There is no private cause of action implied under the Federal Trade Commission Act."
In Count II, Rosenberg seeks a declaration under the federal Declaratory Judgment Act "that the Insurance Policies that are the subject of this Action were unlawfully terminated and/or cancelled and that the policies be immediately reinstated retroactively to the date of the wrongful termination and/or cancellation and the Defendant shall be responsible for any and all damages caused by any wrongful termination and/or cancellation." (Doc. # 8 at 13-14). Thus, Rosenberg essentially seeks a declaration that Blue Cross violated Sections 300gg-2, 300gg-12, and 300gg-42 when it cancelled her insurance policy.
The Court finds that the declaratory judgment claim should be dismissed because Sections 300gg-2, 300gg-12, and 300gg-42 do not create private rights of action.
"Many courts, including the Eleventh Circuit, have held that a claim for declaratory relief must be dismissed where there is no private right of action available for an alleged statutory violation."
"The reasoning behind the prohibition on declaratory relief regarding statutes that do not create private rights of action is especially strong here, where a [government] agency or department is charged with investigating and declaring violations of the statutes at issue."
Therefore, Count II is dismissed with prejudice because Sections 300gg-2, 300gg-12, and 300gg-42 do not create private rights of action.
All the claims raising federal questions have now been dismissed. The remaining claims — under FDUTPA and for breach of contract and breach of the implied covenant of good faith and fair dealing — are governed by state law. Because Rosenberg and Blue Cross are both citizens of Florida (Doc. # 8 at 4), the Court does not have diversity jurisdiction. Therefore, the only basis for the Court to hear the remaining claims is its exercise of supplemental jurisdiction.
"The dismissal of [a plaintiff's] underlying federal question claim does not deprive the Court of supplemental jurisdiction over the remaining state law claims."
Nevertheless, the Eleventh Circuit has "encouraged district courts to dismiss any remaining state claims when, as here, the federal claims have been dismissed prior to trial."
Here, the Court determines it is appropriate to decline the exercise of supplemental jurisdiction over the remaining state claims. Therefore, those claims are dismissed without prejudice so that Rosenberg may re-file them in state court, if she wishes.
Accordingly, it is now