WILLIAM T. LAWRENCE, District Judge.
This cause is before the Court on the Defendants' motion to dismiss (Dkt. No. 36). The motion is fully briefed and the Court, being duly advised,
The State of Indiana and thirty-nine of the state's school corporations bring this suit challenging aspects of and a regulation implementing the Patient Protection and Affordable Care Act ("ACA"). They allege the following facts relevant to the issues raised in the instant motion to dismiss.
"The primary goal of the ACA is to create a health insurance system that provides nearly universal coverage while reducing health care costs." Amended Complaint at ¶ 145. One of the means the ACA uses to further that goal is what is commonly referred to as the "employer mandate." Pursuant to the ACA, a large employer as defined by the Act (which each of the Plaintiffs is or, in the case of one Plaintiff, would be but for efforts to avoid the requirements of the ACA) is required either to offer health insurance that provides "minimum essential coverage" to all of its full-time employees (as defined by the Act) or be subject to a "shared responsibility payment" for failing to do so as set forth in 26 U.S.C. § 4980H. The Plaintiffs aver that each of them offers minimum essential coverage to the majority of its employees, but that each has employees who would be defined as full-time by the Act but who are not eligible for health insurance because they are considered part-time under the Plaintiff's personnel policies (hereinafter referred to as the "Affected Employees"). The Plaintiffs further aver that they do not wish to offer the Affected Employees health insurance because of the cost of doing so.
The shared responsibility payment provision is triggered as to an employer when at least one of its full-time employees purchases insurance from an "American Health Benefit Exchange" ("Exchange") and applies for and is granted a premium tax credit or cost-sharing reduction (hereinafter referred to collectively as a "Tax Credit").
The eligibility requirements for a Tax Credit are set forth in 26 U.S.C. § 36B; one of them is that the individual has enrolled in a qualified health plan "through an Exchange established by the State under section 1311 of the [ACA]." 26 U.S.C. § 36B(c)(2)(A)(i) (defining "coverage month" for which a Tax Credit can be allowed). The Plaintiffs argue that this provision of the ACA and others limit the availability of Tax Credits to individuals who enroll in State Exchanges; accordingly, they argue, there should be no consequence to them if some of their employees purchase insurance from a Federal Exchange and receive a Tax Credit. In other words, the Plaintiffs allege that by deciding not to create a State Exchange, Indiana insulated its employers from the employer mandate by eliminating any consequence for choosing not to provide ACA-compliant health insurance to their employees. See State's Response at 3 (Dkt. No. 38 at 14) ("[I]f no federal subsidies are available in a State because the State has not established its own Exchange, employers in that State will not be subject to the Employer Mandate's tax penalties. Indiana has not established its own Exchange, so by the terms of the ACA Indiana employers should not be subject to the Employer Mandate penalty if they fail to provide sufficient health insurance coverage to full-time employees."
The Defendants disagree with that reading of the ACA. The Internal Revenue Service ("IRS"), as part of its role in implementing the ACA, promulgated a regulation ("the Regulation") in which it defined the term "Exchange" for purposes of determining the eligibility of a Tax Credit as including both State Exchanges and Federal Exchanges, thus making the Tax Credit available to eligible individuals regardless of whether they purchase insurance from a State Exchange or a Federal Exchange. 26 C.F.R. § 1.36B-1(k) (incorporating definition found in 45 C.F.R. § 155.20).
The Plaintiffs in this action allege that the Regulation's definition of "Exchange" creates a conflict with the statutory text of the ACA and will subject them to shared responsibility payments that are not authorized by the ACA. Accordingly, in Count I of their Amended Complaint, the Plaintiffs assert a claim pursuant to the Administrative Procedures Act ("APA"), 5 U.S.C. § 706, arguing that the IRS exceeded its statutory authority and/or abused its discretion when it enacted the Regulation. In Count II, they allege that applying the employer mandate to States and their political subdivisions violates the Tenth Amendment, either because it is a tax that violates the doctrine of intergovernmental tax immunity or, if it is not a tax, because it impermissibly interferes with the residual sovereignty of the State of Indiana. The Plaintiffs make the same allegation in Count III with regard to certain reporting and certification requirements the ACA imposes on employers. They assert in Count IV that the reporting requirements cannot be severed from the employer mandate. Finally, in Count V,
The Defendants advance several grounds in support of their motion to dismiss this case, each of which is addressed, in turn, below.
The Defendants argue that Count I of the Amended Complaint must be dismissed because, for a variety of reasons, the Plaintiffs lack standing to challenge the Regulation. As the Supreme Court explained recently:
Susan B. Anthony List v. Driehaus, ___ U.S. ___, 134 S.Ct. 2334, 2341, 189 L.Ed.2d 246 (2014) (internal citations and quotation marks omitted). "To establish Article III standing, a plaintiff must show (1) an injury in fact, (2) a sufficient causal connection between the injury and the conduct complained of, and (3) a likelihood that the injury will be redressed by a favorable decision." Id. "The party invoking federal jurisdiction bears the burden of establishing standing. Each element must be supported in the same way as any other matter on which the plaintiff bears the burden of proof, i.e., with the manner and degree of evidence required at the successive stages of the litigation." Id. at 2342. In other words, because the Defendants have raised standing in a motion to dismiss, at this stage the Plaintiffs must only show that there is a plausible basis for each element of standing. See, e.g., Adams v. City of Indianapolis, 742 F.3d 720, 728 (7th Cir.2014) ("To survive a motion to dismiss under Rule 12(b)(6), a complaint must `state a claim to relief that is plausible on its face.'" (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007))).
The Defendants' first standing argument is easily disposed of. The Defendants argue that the State's standing to bring this suit cannot be based on the doctrine of parens patriae. The State agrees; indeed, it must agree, because "[a] State does not have standing as parens patriae to bring an action against the Federal Government." Alfred L. Snapp & Son, Inc. v. Puerto Rico ex rel. Barez, 458 U.S. 592, 610, 102 S.Ct. 3260, 73 L.Ed.2d 995 (1982) (citing Massachusetts v. Mellon, 262 U.S. 447, 485-86, 43 S.Ct. 597, 67 L.Ed. 1078 (1923) ("While the State, under some circumstances, may sue in that capacity for the protection of its citizens, it is no part of its duty or power to enforce their rights in respect of their relations with the Federal Government. In that field it is the United States, and not the State, which represents them as parens patriae.") (citation omitted)). Accordingly, to the extent the Plaintiffs have standing to challenge the Regulation, that standing must be based on something other than the quasi-sovereign interests that may only be asserted by means of a parens patriae action.
The Plaintiffs allege that they have standing to sue in their capacity as employers because the employer mandate affects them in that capacity. The Defendants recognize, as they must, that a State and its political subdivisions may sue in their capacity as employers. See, e.g., Alfred L. Snapp & Son, Inc., 458 U.S. at 601-02, 102 S.Ct. 3260 ("[L]ike other associations and private parties, a State is bound to have a variety of proprietary interests. A State may, for example, own land or participate in a business venture. As a proprietor, it is likely to have the same interests as other similarly situated proprietors. And like other such proprietors it may at times need to pursue those interests in court."). However, the Defendants argue that the Plaintiffs lack such standing in this case because the possibility of being subject to a shared responsibility payment in the future is not sufficient to satisfy the "injury in fact" requirement. Specifically, the Defendants argue that the Plaintiffs can only speculate that they will ever be subject to a shared responsibility payment pursuant to § 4980H because "the likelihood of a Section 4980 assessment will turn in part on the future actions of these plaintiffs' employees, namely, whether those employees obtain coverage under a plan offered in the Exchange, and whether those employees receive premium tax credits to assist with the purchase of that coverage" which, in turn, will depend on various circumstances, such as the employees' income, tax filing status, and eligibility for other coverage. Defendants' Brief at 19 (Dkt. No. 37 at 29).
The injury-in-fact requirement "helps to ensure that the plaintiff has a personal stake in the outcome of the controversy." Susan B. Anthony List, 134 S.Ct. at 2341.
Id. (quoting Lujan v. Defenders of Wildlife, 504 U.S. 555, 560, 112 S.Ct. 2130, 119 L.Ed.2d 351 (1992) and Clapper v. Amnesty Int'l USA, ___ U.S. ___, 133 S.Ct. 1138, 1147, 1150 n. 5, 185 L.Ed.2d 264 (2013)). In this case, there is no doubt that the Plaintiffs have a personal stake in the outcome of this litigation — the avoidance of very large shared responsibility payments. The Plaintiffs allege that they have in the past — and would still, but for the Regulation — have (between them) hundreds of employees who work more than 30 hours per week on average and therefore are defined as full-time under the ACA, but who were not entitled to health insurance under the Plaintiffs' personnel policies because they did not satisfy the relevant Plaintiff-employer's definition of full-time (previously defined as the "Affected Employees").
Only one of the Plaintiffs needs to have standing in order for this Court to have jurisdiction over the Plaintiffs' claims. Korte v. Sebelius, 735 F.3d 654, 667 n. 8 (7th Cir.2013) ("Where at least one plaintiff has standing, jurisdiction is secure and the court will adjudicate the case whether the additional plaintiffs have standing or not."). Therefore, the question is whether the Plaintiffs have alleged facts that show
In Lujan, the Supreme Court noted:
Lujan, 504 U.S. 555, 561-62, 112 S.Ct. 2130 (internal citations and quotation marks omitted). The Defendants argue that this "substantially more difficult" standard applies here, and the Plaintiffs have failed to satisfy it. The Court disagrees, for two reasons.
First, while it is literally accurate to assert that the Regulation challenged in this case regulates someone else — individual taxpayers — and not the Plaintiffs, the Court believes that view is too narrow. The Plaintiffs, as employers, are directly regulated by the ACA, and the Regulation
Second, the Defendants argue that the Plaintiffs, like those in Lujan, cannot demonstrate that they will suffer injury here because whether they become liable for shared responsibility payments depends on the actions of the Affected Employees, which they argue are the type of "unfettered choices made by independent actors not before the courts and whose exercise of broad and legitimate discretion the courts cannot presume either to control or to predict" that doomed standing in Lujan. This argument ignores a critical part of the ACA, however: the individual mandate. The Affected Employees' decisions whether to obtain health insurance is not "unfettered"; at least some of them will be required by the ACA to obtain health insurance or face financial consequences of their own. And the Court in this case easily can predict that it is substantially likely that at least one of those employees will comply with the individual mandate by purchasing insurance on the Indiana Exchange (assuming, as the Court must at this stage, that the Tax Credits will be available) because the availability of Tax Credits for individuals making less than 400% of the federal poverty guidelines makes that a particularly economical way to obtain coverage.
The Court finds that the Plaintiffs have satisfied their burden of demonstrating "injury in fact" at this stage of the litigation. It is indeed plausible that at least one of the Affected Employees will (1) be subject to the ACA's individual mandate (or simply wish to obtain health insurance); (2) comply with the individual mandate (or obtain the desired coverage) by purchasing health insurance on the Indiana Exchange; and (3) apply for and receive a Tax Credit for doing so. That is all it would take for the Plaintiff-employer to be injured.
Next, the Defendants argue that the Plaintiffs have not satisfied their burden of showing that it is likely that their injury will be redressed by a favorable ruling because the Affected Employees are not parties to this case and therefore will not be bound by this Court's ruling. Specifically they argue that even if the Plaintiffs win on the merits and obtain the relief they seek — an injunction prohibiting the IRS from awarding Tax Credits to individuals who obtain insurance coverage from a Federal Exchange — that would not stop any of the Affected Employees from "bring[ing] their own claim seeking the award of the tax credit." Defendants' Brief at 21 (Dkt. No. 37 at 31). But just articulating the argument in this way demonstrates its falsity: because only the IRS can grant the Tax Credits, an injunction prohibiting it from doing so would prevent
The Defendants in this case have not suggested how anyone could receive a Tax Credit under the ACA without action by the IRS. In addition, pursuant to 42 U.S.C. § 18081, the Secretary of the Department of Health and Human Services, a Defendant in this case, is responsible for determining an individual's eligibility for a Tax Credit and the amount of that Tax Credit; accordingly, if the Plaintiffs are successful in this action they could obtain a judgment enjoining that Defendant from finding any individual eligible for a Tax Credit if they purchased insurance on a Federal Exchange. It therefore appears to the Court that the Plaintiffs have sued all of the necessary parties in this case to permit redressability of their asserted injuries should they ultimately prevail.
In addition to their standing arguments, the Defendants argue with regard to the Plaintiffs' challenge to the Regulation that the Plaintiffs may only make such a challenge by means of a tax refund action; in other words, the Plaintiffs must pay any shared responsibility payment they are assessed by the IRS and then file a suit seeking a refund in order to challenge the validity of that assessment.
In Counts II through IV, the Plaintiffs allege that applying the employer mandate and related reporting requirements to States and their political subdivisions violates the Tenth Amendment — either because it is a tax that violates the doctrine of intergovernmental tax immunity or, if it is not a tax, because it "impermissibly interfere[s] with the residual sovereignty of the State of Indiana," Amended Complaint at ¶ 211 — and that the reporting requirements are not severable.
The law applicable to federal claim preclusion is well established.
There is no question that the requirements of claim preclusion are satisfied with regard to the Florida Litigation and the Tenth Amendment claims advanced by the State of Indiana in this case. The plaintiffs in that case — including the State of Indiana — alleged the following in Count Six of their Amended Complaint:
Amended Complaint at ¶ 90,
The Supreme Court granted the petition as to several issues; Question 2 was not one of them. Thus the arguments the Plaintiffs wish to make regarding the Tenth Amendment were raised and rejected
The State of Indiana argues that they are entitled to a second bite of the apple because "[t]he Supreme Court has observed `[a] general rule that res judicata is no defense where between the time of the first judgment and the second there has been an intervening decision or a change in the law creating an altered situation,'" and the Supreme Court's ultimate decision in the Florida case "so altered the legal background of the argument that the State's Tenth Amendment claims should not be precluded here." State's Response at 23 (Dkt. No. 38 at 14) (quoting State Farm Mut. Auto. Ins. Co. v. Duel, 324 U.S. 154, 162, 65 S.Ct. 573, 89 L.Ed. 812 (1945)). This argument has several shortfalls.
First, even assuming such a general rule exists, it does not, on its face, apply here. There was no change in the law "between the time of the first judgment and the second"; any change in the law that occurred took place during the course of the Florida Litigation itself. The "first judgment" in this case was the Florida Litigation; nothing has happened since that litigation concluded that has altered the relevant law in any way.
Second, it is far from clear that the quoted language from the State Farm case is good law, inasmuch as the Supreme Court expressed a contrary conclusion in a far more recent case, noting: "Nor are the res judicata consequences of a final, unappealed judgment on the merits altered by the fact that the judgment may have been wrong or rested on a legal principle subsequently overruled in another case." Federated Dept. Stores, Inc. v. Moitie, 452 U.S. 394, 398, 101 S.Ct. 2424, 69 L.Ed.2d 103 (1981). The parties point to no binding authority on the issue of the interplay between Federated and State Farm, either from the Supreme Court or the Seventh Circuit, and the Court's own research has revealed none. With regard to the issue, however, the Court finds the opinion in Pfizer Inc. v. Ranbaxy Labs. Ltd., 525 F.Supp.2d 680, 689-90 (D.Del.2007), both instructive and persuasive:
Accord Roche Palo Alto LLC v. Apotex, Inc., 531 F.3d 1372 (Fed.Cir.2008) (citing Federated for the proposition that "there is no `change of law' or fairness exception to prevent application of claim preclusion").
452 U.S. at 401, 101 S.Ct. 2424 (citations and internal quotation marks omitted).
In any event, the Court is unconvinced by the State of Indiana's argument that the Supreme Court's decision in NFIB was the type of "momentous legal change" in Tenth Amendment jurisprudence that would justify overlooking the preclusive effect of the Florida Litigation. Principles discussed and applied in NFIB are certainly relevant to the Plaintiffs' claims in this case, and perhaps, as they suggest, the Supreme Court's application of those principles in that case may support some of the Plaintiffs' arguments in this case, making them somewhat stronger than they would be but for the NFIB decision, but the State has identified no clear change in the law such that there are arguments available to them now that were unavailable to them in the Florida Litigation.
There are three aspects of the State of Indiana's argument that remain to be addressed. First, the State argues at length that "[c]ase law involving the Bipartisan Campaign Reform Act of 2002," another complex federal statute, lends support to its position that claim preclusion should not apply here. Specifically, the State notes that Republican Nat'l Committee v. Fed. Election Comm'n, 698 F.Supp.2d 150, 156 (D.D.C.2010), aff'd, 561 U.S. 1040, 130 S.Ct. 3544, 177 L.Ed.2d 1119 (2010) ("RNC") was decided on the merits, in
Second, the State argues that claim preclusion should not apply because of "factual changes" that have occurred, arguing that claim preclusion "`does not bar parties from bringing claims based on material facts that were not in existence when they brought the original suit.'" State's Response at 26 (Dkt. No. 38 at 37) (quoting Apotex v. Food & Drug Admin., 393 F.3d 210, 218 (D.C.Cir.2004)). The key word is material. None of the facts material to whether the employer mandate violates the Tenth Amendment have changed. In the Florida Litigation, as summarized by the district court, the plaintiffs argued that the employer mandate "require[d] the states, in their capacities as large employers, to offer and automatically enroll state employees in federally-approved insurance plans or else face substantial penalties and assessments." Florida, 716 F.Supp.2d at 1151. The court expressly assumed that it was true that "the employer mandate will be costly and burdensome to the states in their capacity as large employers," id., and nonetheless found that it did not violate the Tenth Amendment. The fact that the parties are better able to quantify the cost and burdens they face and have taken steps to minimize them would not have changed the Tenth Amendment analysis in any way, and therefore it is not a material change.
Finally, the State of Indiana argues that claim preclusion does not apply to its challenge in Count III to the ACA's employer reporting requirements because, it argues, the reporting requirements were not challenged in the Florida Litigation. As the Defendants correctly point out, that assertion is incorrect. The amended complaint in the Florida Litigation asserted that there were three "new requirements" imposed by the ACA that interfered with the state plaintiffs' "ability to perform government functions": (1) the requirement to enroll employees working 30 or more hours a week into health insurance plans; (2) the imposition of substantial penalties and taxes "for State employees who obtain subsidized insurance from an exchange instead of from a State plan, or if the State plan offers coverage that is either too little or too generous as determined by the federal
For the reasons set forth above, the Court finds that the State of Indiana is barred by res judicata from arguing that the employer mandate — including the reporting requirements — violates the Tenth Amendment. Accordingly, the motion to dismiss is
The School Districts were not parties to the Florida Litigation; therefore, the judgment in that case can have preclusive effect on the School Districts' claims in this case only if they were in privity with the State of Indiana. This requires a "fact-specific analysis," and "whether there is privity between a party against whom claim preclusion is asserted and a party to prior litigation is a functional inquiry in which the formalities of legal relationships provide clues but not solutions." Bernstein v. Bankert, 733 F.3d 190, 226 (7th Cir.2013) (citations omitted).
The cornerstone of the Defendants' argument that there is privity between the School Districts and the State of Indiana with regard to the Florida Litigation is their assertion that "[t]he school districts' Tenth Amendment rights, if any, derive from those of the state." Defendants' Brief at 30 (Dkt. No. 37 at 40). The Defendants cite to no authority for this proposition, and in light of the holding in Bond v. United States, ___ U.S. ___, 131 S.Ct. 2355, 180 L.Ed.2d 269 (2011), it is not clear to the Court that it is a correct statement of the law. The Court believes that this issue would benefit from oral argument — to specifically address the import, if any, of the principles set forth in Bond, and also to more fully address the arguments made in the parties' briefs. Accordingly, the motion to dismiss is
Finally, in Count V, the Plaintiffs allege that the Federal Government is estopped from imposing any assessable payments on employers for noncompliance with the employer mandate in 2014 because
For the reasons set forth above, the Defendants' motion to dismiss (Dkt. No. 36) is
Finally, the Plaintiffs' motion for consolidated oral argument (Dkt. No. 50) is
SO ORDERED: