HARTZ, Circuit Judge.
Lee Ann Helfrich received benefits through her federal-employee health-insurance plan, the Blue Cross and Blue Shield Service Benefit Plan (the Plan), for the treatment of injuries she sustained in a car accident. After Ms. Helfrich reached a settlement with the other driver's insurance company, Blue Cross and Blue Shield Association (BCBSA) and Blue Cross and Blue Shield of Kansas City (BCBSKC) sought reimbursement for the benefits paid, as provided in the terms of the Plan. Ms. Helfrich appeals from the judgment of the United States District Court for the District of Kansas requiring her to reimburse BCBSA and BCBSKC (together Blue Cross) because the Federal Employees Health Benefits Act of 1959 (FEHBA) preempts a Kansas insurance regulation prohibiting subrogation and reimbursement clauses in insurance contracts. Exercising jurisdiction under 28 U.S.C. § 1291, we affirm. Ms. Helfrich must reimburse Blue Cross because federal common law displaces the Kansas antisubrogation regulation, which, if applied to the Plan, would conflict with uniquely federal interests. Alternatively, giving weight to the views of the Office of Personnel Management (OPM) regarding the meaning of FEHBA's preemption provision, 5 U.S.C. § 8902(m)(1), we hold that the reimbursement provision in the Plan "relate[s] to the nature, provision, or extent of coverage or benefits," id., and therefore supersedes state law.
FEHBA establishes a program to provide health insurance for federal employees and annuitants. See 5 U.S.C. §§ 8901-8914 (2012 ed. and Supp. I). Its purpose is to provide affordable quality healthcare to government employees. See Doe v. Devine, 703 F.2d 1319, 1329 n. 41 (D.C.Cir. 1983) ("FEHBA's goal is to ensure maximum health benefits for employees `at the lowest possible cost to themselves and to the Government.'" (quoting H.R.Rep. No. 86-957, at 4 (1959)), 1959 U.S.C.C.A.N. 2913, 2916).
FEHBA authorizes OPM to enter into contracts with insurance carriers and promulgate regulations to carry out the program. See 5 U.S.C. § 8902(a); id. § 8913(a). OPM has contracted with BCBSA for the Plan, which is administered by local Blue Cross and Blue Shield companies. See id. § 8903(1). Under FEHBA the federal government pays approximately 70% of an enrollee's premium, and the enrollee pays the remainder. See id. § 8906(b); 80 Fed.Reg. 29,203. Premiums from the government and enrollees are deposited into the Employees Health Benefits Fund within the United States Treasury. See 5 U.S.C. § 8909(a). BCBSA, like other experience-rated carriers, draws from the Fund as necessary to pay for benefit claims and administrative expenses, see 48 C.F.R. § 1632.170(b); id. § 1652.216-71(b), and the government pays a negotiated fee for its services, see id. § 1615.404-4. In other words, any premiums that are not used to pay benefits or administrative expenses remain the property of the government, and BCBSA earns its profit from the service fee. Community-rated
FEHBA requires that OPM's contracts with carriers "contain a detailed statement of benefits offered and shall include such maximums, limitations, exclusions, and other definitions of benefits as [OPM] considers necessary or desirable." 5 U.S.C. § 8902(d). The contract between OPM and BCBSA states that "[t]he Carrier shall provide the benefits as described in the agreed upon brochure text" attached as an appendix, J.App., Vol. 1 at 57; the brochure is "the official statement of benefits," id. at 131.
The contract also provides that "[t]he Carrier's subrogation rights, procedures and policies, including recovery rights, shall be in accordance with the provisions of the agreed upon brochure text." Id. at 61.
FEHBA's preemption provision, 5 U.S.C. § 8902(m)(1), states: "The terms of any contract under this chapter which relate to the nature, provision, or extent of coverage or benefits (including payments with respect to benefits) shall supersede and preempt any State or local law, or any regulation issued thereunder, which relates to health insurance or plans." In June 2012, OPM issued a letter to all FEHBA carriers expressing its position that contractual rights to reimbursement and subrogation fall within the purview of § 8902(m)(1) and thus override state laws that relate to health insurance or plans. On January 7, 2015, OPM published in the Federal Register a proposed rule addressing the preemption of state laws limiting subrogation and reimbursement. See 80 Fed.Reg. 931. After notice and comment, OPM promulgated the final rule on May 21, 2015 (while this litigation was pending). See id. at 29,203. The rule states, "All health benefit plan contracts shall provide that the Federal Employees Health Benefits (FEHB) carrier is entitled to pursue subrogation and reimbursement recoveries, and shall have a policy to pursue such recoveries in accordance with the terms of this section." Id. at 29,204 (codified at 5 C.F.R. § 890.106(a)). The rule also requires that contracts containing subrogation or reimbursement clauses "provide that benefits and benefit payments are extended to a covered individual on the condition that the FEHB carrier may pursue and receive subrogation and reimbursement recoveries pursuant to the contract." Id. (codified at 5 C.F.R. § 890.106(b)(2)). Finally, the rule declares that state laws limiting subrogation and reimbursement are preempted under § 8902(m)(1):
Id. at 29,205 (codified at 5 C.F.R. § 890.106(h)).
Ms. Helfrich is a federal employee enrolled in the Plan; BCBSKC administers the Plan in her area. In December 2012, Ms. Helfrich was in a car accident and suffered serious injuries. She received $76,561.88 in benefits from the Plan in connection with her injuries. Ms. Helfrich asserted a claim against the other driver in the accident and settled with the driver's insurer for the policy limit of $100,000. Blue Cross then sought reimbursement for the benefits paid according to the terms of the Plan. In response, Ms. Helfrich filed a petition against Blue Cross in Kansas state court seeking a declaration that the subrogation clause in the Plan is unenforceable under Kansas law and that § 8902(m)(1) does not preempt the Kansas antisubrogation regulation, which provides that "[n]o insurance company or health insurer . . .
Blue Cross removed the case to federal court
"We review a district court's grant of a motion for judgment on the pleadings de novo, using the same standard that applies to a Rule 12(b)(6) motion." Colony Ins. Co. v. Burke, 698 F.3d 1222, 1228 (10th Cir.2012) (internal quotation marks omitted). We affirm the district court's grant of judgment on the pleadings for Blue Cross on the grounds that (1) federal common law displaces the Kansas antisubrogation regulation and (2) the FEHBA preemption provision overrides the regulation. Although the district court did not address the first ground or some of the reasoning supporting the second, we can properly rely on them to affirm because Blue Cross raised them below, they were briefed, and Blue Cross raises them again on appeal. See Havens v. Johnson, 783 F.3d 776, 782 (10th Cir.2015).
Blue Cross argues that federal common law displaces the Kansas antisubrogation regulation under the doctrine set forth in Boyle v. United Technologies Corp., 487 U.S. 500, 108 S.Ct. 2510, 101 L.Ed.2d 442 (1988). In Boyle a United States Marine helicopter copilot was killed when his helicopter crashed off the coast of Virginia. See id. at 502, 108 S.Ct. 2510. The copilot survived the crash but was unable to escape from the helicopter and drowned. See id. The plaintiff, on behalf of the copilot's heirs and estate, brought a diversity action against the contractor that built the helicopter for the United States, claiming that it was liable under Virginia tort law for a defectively designed escape hatch, which opened out instead of in, see id. at 502-03, 108 S.Ct. 2510, as stated in the contract specifications, see id. at 509, 108 S.Ct. 2510. Ultimately the Supreme Court held that even in the absence of an applicable statute, federal law protected a federal contractor against design-defect liability under state law if "(1) the United States approved reasonably precise specifications; (2) the equipment conformed to those specifications; and (3) the supplier warned the United States about the dangers in the use of the equipment that were known to the supplier but not to the United States." Id. at 512, 108 S.Ct. 2510. Because the path taken by the Court to reach that conclusion is essential to our analysis, we review it in some detail.
First, the Court rejected the plaintiff's argument that it could not recognize a
Boyle did not precisely concern either interest; but the Court found the differences unimportant. "[T]he reasons for considering these closely related areas to be of `uniquely federal' interest," said the Court, "apply as well to the civil liabilities arising out of the performance of federal procurement contracts." Id. at 505-06, 108 S.Ct. 2510. Regarding the first interest, the Court acknowledged that the case did "not involve an obligation to the United States under its contract, but rather liability to third persons." Id. at 505, 108 S.Ct. 2510. The contractor's design-defect tort liability, however, arose "out of performance of the contract" and such liability had been traditionally regarded as closely related to the contract for the allegedly defective item. Id. Similarly, the Court recognized that even though the case "involve[d] an independent contractor performing its obligation under a procurement contract, rather than an official performing his duty as a federal employee," in both circumstances "there is obviously implicated the same interest in getting the Government's work done." Id.
The Court concluded that these reasons made "civil liabilities arising out of the performance of federal procurement contracts" a matter of uniquely federal interest. Id. at 506, 108 S.Ct. 2510. The Court added that this view was nothing new, pointing out that in 1940 the Court had held that a federal contractor could not be liable in a private suit for erosion allegedly caused by dike construction work, saying that "`if the authority to carry out the project was validly conferred, that is, if what was done was within the constitutional power of Congress, there is no liability on the part of the contractor for executing its will.'" Id. (brackets omitted) (quoting Yearsley v. W.A. Ross Constr. Co., 309 U.S. 18, 20-21, 60 S.Ct. 413, 84 L.Ed. 554 (1940)). Thus, although the dispute in Boyle was between private parties, the interests of the United States were still directly implicated. See id. at 506-07, 108 S.Ct. 2510.
Displacement of state law, however, requires more than just the presence of a uniquely federal interest. "Displacement will occur only where . . . a significant conflict exists between an identifiable federal policy or interest and the operation of state law, or the application of state law would frustrate specific objectives of federal legislation." Id. at 507, 108 S.Ct. 2510 (brackets, citation, and internal quotation marks omitted). Displacement of state law on these grounds could be necessary even if preemption of state law would otherwise not be in order:
Id. at 507-08, 108 S.Ct. 2510 (emphasis added) (citation, footnote, and internal quotation marks omitted). The extent of the preemption could vary. "In some cases, for example where the federal interest requires a uniform rule, the entire body of state law applicable to the area conflicts and is replaced by federal rules." Id. at 508, 108 S.Ct. 2510 (citing Clearfield Trust Co. v. United States, 318 U.S. 363, 63 S.Ct. 573, 87 L.Ed. 838 (1943)). But in other cases "the conflict is more narrow, and only particular elements of state law are superseded." Id.
On the other hand, no conflict, no displacement. The Court discussed its prior opinion in Miree v. DeKalb County, 433 U.S. 25, 26-27, 97 S.Ct. 2490, 53 L.Ed.2d 557 (1977), as an example of a case in which there was no adequate federal interest and no conflict with federal policy. In Miree the plaintiffs alleged that a plane crashed because the County had a garbage dump too close to the airport, closer than permitted in the County's grant contracts with the Federal Aviation Administration (FAA). See id. at 26-27, 97 S.Ct. 2490. They argued that they could sue under state law as third-party beneficiaries of the contracts. See id. at 27, 97 S.Ct. 2490. The Court held that state law, rather than federal common law, applied to the plaintiffs' claims because "[t]he operations of the United States in connection with FAA grants . . . would [not] be burdened or subjected to uncertainty by variant state-law interpretations regarding whether those with whom the United States contracts might be sued by third-party beneficiaries to the contracts." Id. at 30, 97 S.Ct. 2490. "[A]ny federal interest in the outcome of the question before [the Court] [was] far too speculative, far too remote a possibility to justify the application of federal law to transactions essentially of local concern." Id. at 32-33, 97 S.Ct. 2490 (internal quotation marks omitted). In contrast, the federal interest in Boyle was quite real. As the Boyle Court said, "The imposition of liability on Government contractors will directly affect the terms of Government contracts: either the contractor will decline to manufacture the design specified by the Government, or it will raise its price." 487 U.S. at 507, 108 S.Ct. 2510. Further, the plaintiffs in Miree were "not seeking to impose upon the person contracting with the Government a duty contrary to the duty imposed by the Government contract" but instead were seeking to enforce "the contractual duty itself" Id. at 508, 108 S.Ct. 2510. Boyle, however, was "at the opposite extreme from Miree" because Virginia's tort-law duty of care was "precisely contrary" to the duty imposed by the government contract. Id. at 509, 108 S.Ct. 2510.
Finally, Boyle had to formulate when a contractor's tort liability for a design defect that appears in the contract's specifications creates "a significant conflict with federal policy or interests." Id. (internal quotation marks omitted). Not every tort claim would present such a conflict. "If, for example, a federal procurement officer orders, by model number, a quantity of stock helicopters that happen to be equipped with escape hatches opening out-ward, it is impossible to say that the Government has a significant interest in that particular feature." Id.
For guidance, the Court turned to the Federal Tort Claims Act (FTCA). The
Id. at 511-12, 108 S.Ct. 2510. The Court concluded that the contractor should not be liable in tort if the government would not have been. "It makes little sense," said the Court, "to insulate the Government against financial liability for the judgment that a particular feature of military equipment is necessary when the Government produces the equipment itself, but not when it contracts for the production." Id. at 512, 108 S.Ct. 2510. In other words, in that circumstance—when state law was contrary to a contract term actually selected by the federal agency (a "discretionary" decision)—there would be a "significant conflict" between government policy and state tort liability of the contractor. The requirements set forth by the Court for contractor design-defect liability ensured that contractor immunity would be available when the design defect was the product of a discretionary decision by the government.
In our view, the analysis in Boyle requires the displacement of the Kansas antisubrogation regulation in the context of the Blue Cross claim against Ms. Helfrich. The concurrence suggests that Boyle's analysis applies only to the displacement of state tort law. But the policy considerations expressed in Boyle are independent of the nature of the state cause of action. The state laws addressed by the precedents relied on in Boyle were not just tort laws. See, e.g., Clearfield Trust, 318 U.S. 363, 63 S.Ct. 573 (commercial paper); Miree, 433 U.S. 25, 97 S.Ct. 2490 (third-party-beneficiary claim). Boyle introduced the FTCA's discretionary-function standard as simply a test to determine whether there was a significant conflict between a term of a government contract and state law—the conflict was significant if the term was the informed discretionary decision of the contracting officer. State law—whether tort law or otherwise—must yield if it conflicts with such a contractual term in an area of uniquely federal interests.
There can be little debate that the contract between BCBSA and the government and the provision of affordable quality healthcare to government employees are both matters of "uniquely federal" interest. "The United States no doubt has an overwhelming interest in attracting able workers to the federal workforce and in the health and welfare of the federal workers upon whom it relies to carry out its functions." Empire Healthchoice Assurance, Inc. v. McVeigh, 547 U.S. 677, 701, 126 S.Ct. 2121, 165 L.Ed.2d 131 (2006) (internal quotation marks omitted).
There is also a strong federal interest in uniformity that is undermined by allowing state law to override the subrogation and reimbursement requirements of the federal contract. See United States v. Kimbell Foods, Inc., 440 U.S. 715, 728, 99 S.Ct. 1448, 59 L.Ed.2d 711 (1979) ("federal programs that by their nature are and must be uniform in character throughout the Nation necessitate formulation of controlling federal rules" (internal quotation marks omitted)). Recognition of state antisubrogation laws would create unfairness within the ranks of government employees. Those in states without such laws would have to pay reimbursements that are then used to benefit enrollees throughout the country, even those who live in states where they could keep their tort recoveries without paying reimbursements. See FMC Corp. v. Holliday, 498 U.S. 52, 60, 111 S.Ct. 403, 112 L.Ed.2d 356 (1990) ("Pennsylvania's antisubrogation law . . . requires plan providers to calculate benefit levels in Pennsylvania based on expected liability conditions that differ from those in States that have not enacted similar antisubrogation legislation. Application of differing state subrogation laws to plans would therefore frustrate plan administrators' continuing obligation to calculate uniform benefit levels nationwide."). The legislative history of FEHBA confirms the congressional interest in uniformity. In enacting the FEHBA provision preempting certain state laws (a provision we address more fully in the next section of the opinion), Congress expressed concern that the imposition of state-law requirements on FEHBA contracts would result in "[a] lack of uniformity of benefits for enrollees in the same plan which would result in enrollees in some States paying a premium based, in part, on the cost of benefits provided only to enrollees in other States." H.R.Rep. No. 95-282, at 4 (1977); see also 80 Fed.Reg. at 29,203 (supplementary information introducing OPM's recent rule explains that the preemption of state antisubrogation laws "furthers Congress's goals of . . . enabling uniform, nationwide application of FEHB contracts").
The Seventh Circuit considered a similar issue in Downey v. State Farm Fire & Casualty Co., 266 F.3d 675 (7th Cir.2001), in which an insured brought suit against his insurer on a policy bought through the National Flood Insurance Program (NFIP). See id. at 678, 681-82. The court noted that under the program the private insurer, State Farm, remitted all premiums, minus a fee, to the Federal Emergency Management Agency (FEMA), and if the insurer paid a claim it was reimbursed by FEMA. See id. at 679. State Farm acted merely as an administrative agent, selling policies and processing claims for FEMA. See id. at 679-80. The court concluded that the federal interest justified the application of federal law to the suit:
Id. at 681.
The Supreme Court's decision in O'Melveny & Myers v. FDIC, 512 U.S. 79, 114 S.Ct. 2048, 129 L.Ed.2d 67 (1994), does not conflict with our analysis. The Federal Deposit Insurance Corporation (FDIC), as receiver of a California-chartered federally insured savings and loan (S & L) sued attorneys who provided services to the S & L for negligence and breach of fiduciary duty with respect to fraudulent conduct by S & L officers. See id. at 81-82, 114 S.Ct. 2048. One defense of the attorneys was that, under California law, knowledge of the fraud must be imputed to the S & L, and therefore to the FDIC. See id. at 82-83, 114 S.Ct. 2048. The FDIC argued that federal, not state, law governed imputation and federal law would not recognize the defense. See id. at 83, 114 S.Ct. 2048. The Court saw no conflict with federal law that would require the displacement of state law governing imputation. See id. at 85, 89, 114 S.Ct. 2048. It observed that the FDIC had "identified no significant conflict with an identifiable federal policy or interest." Id. at 88, 114 S.Ct. 2048.
Several statements by the Court might at first seem to argue against displacement of state law in our case. But not after a closer look. First, the Court rejected the FDIC's argument that California law could compromise federal interests because "state rules regarding the imputation of knowledge might deplete the deposit insurance fund." Id. (brackets and internal quotation marks omitted). The FDIC's argument proved too much. "[N]either [the relevant statute] nor the
Second, the Court in O'Melveny & Myers declared that in that case "[t]here [was] not even at stake that most generic (and lightly invoked) of alleged federal interests, the interest in uniformity." Id. But here we have the federal interest in uniform treatment of federal employees—in particular, not requiring some to subsidize others in ways (such as an antisubrogation law) not available to all.
And finally, O'Melveny & Myers said that the Court would not "adopt a court-made rule to supplement federal statutory regulation that is comprehensive and detailed; matters left unaddressed in such a scheme are presumably left subject to the disposition provided by state law." Id. at 85. But this statement arose in the context of a statute that provided detail about the terms on which the FDIC could sue as receiver, creating "special federal rules of decision regarding claims by, and defenses against, the FDIC as receiver." Id. at 86. In contrast, FEHBA is silent regarding claims by insurers against enrollees or tortfeasors; subrogation and reimbursement rules are not mentioned. To be sure, FEHBA has a preemption provision; but even if the provision does not cover reimbursement claims (a proposition we reject in the next section of this opinion), that limitation cannot override the strong federal interests in displacing state law in our case. See Geier v. Am. Honda Motor Co., 529 U.S. 861, 869, 120 S.Ct. 1913, 146 L.Ed.2d 914 (2000) (express "pre-emption provision, by itself, does not foreclose (through negative implication) any possibility of implied conflict pre-emption" (brackets and internal quotation marks omitted)); Boyle, 487 U.S. at 507-08, 108 S.Ct. 2510 ("the fact that the area in question is one of unique federal concern changes what would otherwise be a conflict that cannot produce pre-emption into one that can" (footnote omitted)); United States v. Northrop Corp., 59 F.3d 953, 961 n. 4 (9th Cir.1995) ("[W]e do not think that the Supreme Court in O'Melveny intended to foreclose the possibility of displacing, with a federal common law rule, a state rule of decision that would conflict with specific policies of a comprehensive federal scheme."); cf. Freightliner Corp. v. Myrick, 514 U.S. 280, 288, 115 S.Ct. 1483, 131 L.Ed.2d 385 (1995) ("The fact that an express definition of the pre-emptive reach of a statute `implies'—i.e., supports a reasonable inference—that Congress did not intend to pre-empt other matters does not mean that the express clause entirely forecloses any possibility of implied pre-emption.").
Nor is our ruling in tension with McVeigh, 547 U.S. 677, 126 S.Ct. 2121, a case in which a FEHBA insurer sought reimbursement from an enrollee out of a tort settlement. McVeigh did not say that state law necessarily controlled reimbursement claims under a FEHBA contract. It held only that there was no federal-question jurisdiction over such a reimbursement claim, thus requiring dismissal of the insurer's claim. See id. at 683, 126 S.Ct. 2121. (There is no jurisdictional issue in our case, given the diversity of citizenship of the parties.)
To be sure, such federal interests do not necessarily require displacement. The Court explained that under Boyle, "the involvement of an area of uniquely federal interest establishes a necessary, not a sufficient, condition for the displacement of state law." Id. at 692, 126 S.Ct. 2121 (ellipsis and internal quotation marks omitted). Noting that the Second Circuit had determined that the carrier had not shown a significant conflict between a federal interest and state law (no state antisubrogation law was mentioned), the Court said, "Unless and until that showing is made, there is no cause to displace state law, much less to lodge this case in federal court." Id. at 693, 126 S.Ct. 2121. Implicit in this statement, however, is that a state regulation that directly conflicts with federal interests must be displaced. And the Second Circuit, without rebuke by the Supreme Court, said as much. See Empire HealthChoice Assurance, Inc. v. McVeigh, 396 F.3d 136, 142 (2d Cir.2005) (Sotomayor, J.) ("We recognize the possibility that at a later stage in the proceedings, a significant conflict might arise between New York state law and the federal interests underlying FEHBA, such that the dispute would satisfy both prongs of Boyle. If, for example, [the estate's administrator] were to defend herself in reliance upon a state law that was meant to advance a particular state policy, [the carrier] could argue that such state law—whether statutory or common law—conflicts with federal interests and requires the application of federal common law. This possibility, however, is insufficient to confer federal jurisdiction."). In this case there is certainly such a conflict, with the state law attempting to nullify a provision in the FEHBA contract.
Ms. Helfrich relies on McVeigh's statement that "the reimbursement right in question, predicated on a FEHBA-authorized contract, is not a prescription of federal law." Id.; see also id. (carrier's "contract-derived claim for reimbursement is not a creature of federal law" (brackets and internal quotation marks omitted)); id. at 692, 126 S.Ct. 2121 (reimbursement and subrogation provisions in OPM-BCBSA contract "are linked together and depend upon a recovery from a third party under terms and conditions ordinarily governed by state law"). But even if that is of critical importance in determining whether a claim arises under federal law for purposes of federal jurisdiction, it is hardly dispositive on the issue of displacement of state law. Indeed, the displacement issue (under federal common law) does not arise if a federal statute sets forth the controlling standard. Although reimbursement is generally governed by state law, federal law may nonetheless displace aspects of that law. After all, a design-defect tort claim is a creature of state law, but that did not preclude the displacement of part of that law in Boyle. See 487 U.S. at 512, 108 S.Ct. 2510.
Blue Cross also raises FEHBA's preemption provision as a ground for overriding the Kansas antisubrogation regulation. The provision states:
5 U.S.C. § 8902(m)(1).
The Supreme Court discussed this provision in McVeigh. Although the issue in that case was federal-question jurisdiction, not the preemption of state law, the Court's observations are nevertheless relevant. It said that the provision is "unusual in that it renders preemptive contract terms in health insurance plans, not provisions enacted by Congress," and thus "warrants cautious interpretation." McVeigh, 547 U.S. at 697, 126 S.Ct. 2121. It also noted the provision's ambiguity, at least with respect to reimbursement:
Id. (citation omitted, ellipses in original). The Court, however, did not need to choose between these "plausible constructions" because "even if FEHBA's preemption provision reaches contract-based reimbursement claims, that provision is not sufficiently broad to confer federal jurisdiction." Id. at 698, 126 S.Ct. 2121.
Given the Supreme Court's statement that the provision is ambiguous regarding the preemptive effect of reimbursement clauses, Ms. Helfrich argues that we must apply the well-established presumption against preemption, see, e.g., Wyeth v. Levine, 555 U.S. 555, 565, 129 S.Ct. 1187, 173 L.Ed.2d 51 (2009), and conclude that Kansas law is not preempted. But that presumption does not apply here for much the same reason that, as discussed in the prior section of this opinion, federal law displaces the Kansas antisubrogation regulation. The Supreme Court has at least twice recognized a federal-interest exception to the general presumption against preemption.
Similarly, in United States v. Locke, 529 U.S. 89, 108, 120 S.Ct. 1135, 146 L.Ed.2d 69 (2000), the Court said that "an `assumption' of nonpre-emption is not triggered when the State regulates in an area where there has been a history of significant federal presence." The issue in Locke was the preemption of state regulations governing tanker-ship operations and design. See id. at 94, 120 S.Ct. 1135. The presumption against preemption was inapplicable because these laws touched upon "national and international maritime commerce," a field in which "Congress ha[d] legislated . . . from the earliest days of the Republic, creating an extensive federal statutory and regulatory scheme." Id. at 108, 120 S.Ct. 1135.
This court has followed that lead. In US Airways, Inc. v. O'Donnell, 627 F.3d 1318, 1325 (10th Cir.2010), we considered whether New Mexico liquor laws applied to airline flights in the state. We said that the presumption against preemption did not apply to the preemption of a state's regulation of an airline's alcoholic-beverage service because "the field of aviation safety has long been dominated by federal interests." Id. at 1325 (internal quotation marks omitted). This despite the constitutional recognition of the state interest in regulation of liquor, see U.S. Const. amend. XXI, § 2 ("The transportation or importation into any State, Territory, or possession of the United States for delivery or use therein of intoxicating liquors, in violation of the laws thereof, is hereby prohibited."), which was discussed at length later in our opinion, see O'Donnell, 627 F.3d at 1329-31.
The federalism concern (respecting state sovereignty) behind the presumption against preemption has little purchase in this case. The preemption provision does not affect the relationships between private citizens. Section 8902(m)(1) governs only contracts for the benefit of federal employees. It is an understatement to say that "there has been a history of significant federal presence," Locke, 529 U.S. at 108, 120 S.Ct. 1135, in the area of federal employment. Congress has legislated on the matter from the outset.
To begin with, the subrogation and reimbursement requirements in the Plan are tied directly to "payments with respect to benefits." § 8902(m)(1). They are triggered when a third party injures an enrollee and the Plan "pa[ys] benefits for that injury." J.App., Vol. 1 at 140. If the enrollee recovers from the third party, those recoveries "must be used to reimburse [the Plan] in full for benefits [it] paid." Id. The Plan may "enforce [its] right of recovery by offsetting future benefits." Id. at 141. And if the enrollee does not seek to recover from the third party, she must permit the Plan to initiate recovery on her behalf. Thus, a carrier's contractual right to reimbursement and subrogation arises from its payment of benefits; and an enrollee's ultimate entitlement to benefit payments is conditioned upon providing reimbursement from any later recovery or permitting the Plan to recover on the enrollee's behalf. No wonder that the reimbursement and subrogation requirements are contained in the Plan's "statement of benefits." Id. at 131. We note that several circuit courts have interpreted an ERISA provision authorizing civil actions to "recover benefits due. . . under the terms of [a] plan," 29 U.S.C. § 1132(a)(1)(B), as encompassing suits disputing a plan's reimbursement efforts. See Levine v. United Healthcare Corp., 402 F.3d 156, 163 (3d Cir.2005) ("Where, as here, plaintiffs claim that their ERISA plan wrongfully sought reimbursement of previously paid health benefits, the claim is for `benefits due'. . . ."); Arana v. Ochsner Health Plan, 338 F.3d 433, 437-38 (5th Cir.2003); Singh v. Prudential Health Care Plan, Inc., 335 F.3d 278, 291 (4th Cir.2003). But see Wurtz v. Rawlings Co., 761 F.3d 232, 242 (2d Cir.2014).
Further, the reimbursement and subrogation provisions of the Plan have a second close connection to benefits. Any recovery through these provisions goes to a Treasury fund that may be used to reduce premiums or to increase benefits. See 5 U.S.C. § 8909(b); 5 C.F.R. § 890.503(c)(2).
The legislative history of § 8902(m)(1) also lends some support. The history reveals a concern about state interference with cost-cutting measures and the uniform treatment of federal employees across the nation. The House Report on the original measure expressed fear that the imposition of state-law requirements on FEHBA contracts would result in "[i]ncreased premium costs to both the Government and enrollees, and [a] lack of uniformity of benefits for enrollees in the same plan which would result in enrollees in some States paying a premium based, in part, on the cost of benefits provided only to enrollees in other States." H.R.Rep. No. 95-282, at 4 (1977); see also H.R. Rep.
The position of Blue Cross has been embraced in the decisions by other federal courts, which have said that FEHBA preempts state laws limiting subrogation and reimbursement. See Shields v. Gov't Emps. Hosp. Ass'n, 450 F.3d 643, 648 (6th Cir.2006), overruled on other grounds by Adkins v. Wolever, 554 F.3d 650, 652 (6th Cir.2009); MedCenters Health Care v. Ochs, 26 F.3d 865 (8th Cir.1994), overruled on jurisdictional grounds by McVeigh, 547 U.S. 677, 126 S.Ct. 2121; Bell v. Blue Cross & Blue Shield of Okla., No. 5:14-CV-05046, 2014 WL 5597265, at *6-8 (W.D.Ark. Nov. 3, 2014) (following MedCenters); Calingo v. Meridian Res. Co., No. 11 CV 628(VB), 2013 WL 1250448, at *4 (S.D.N.Y. Feb. 20, 2013); cf. Bryan v. Office of Pers. Mgmt., 165 F.3d 1315, 1320 (10th Cir.1999) (interpreting § 8902(m)(1) broadly to preempt state law allowing courts to award attorney fees to the prevailing party in a suit between an insured and insurer). The state courts are divided. Compare Thurman v. State Farm Mut. Auto. Ins. Co., 278 Ga. 162, 598 S.E.2d 448, 451 (2004) (state law preempted), and Aybar v. N.J. Transit Bus Operations, Inc., 305 N.J.Super. 32, 701 A.2d 932, 937 (N.J.Super.Ct.App.Div.1997) (same), with Nevils v. Grp. Health Plan, Inc., 418 S.W.3d 451, 457 (Mo.2014) (en banc) (No preemption because "[t]he subrogation provision in favor of [the FEHBA carrier] creates a contingent right to reimbursement and bears no immediate relationship to the nature, provision or extent of [the enrollee's] insurance coverage and benefits. . . ."), vacated and remanded ___ U.S. ___, 135 S.Ct. 2886, ___ L.Ed.2d ___ (2015), Kobold v. Aetna Life Ins. Co., 233 Ariz. 100, 309 P.3d 924, 928 (Ct.App. 2013) (same), vacated and remanded ___ U.S. ___, 135 S.Ct. 2886, ___ L.Ed.2d ___ (2015), and Hillenbrand v. Meyer Med. Grp., S.C., 308 Ill.App.3d 381, 241 Ill.Dec. 832, 720 N.E.2d 287, 292-94 (1999) (application of common-fund doctrine not preempted).
Strongly buttressing the decisions finding preemption is a recent regulation issued by OPM, the agency responsible for administering FEHBA.
Blue Cross and the United States argue that we must defer to OPM's interpretation of § 8902(m)(1) under Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837, 104 S.Ct. 2778, 81 L.Ed.2d 694 (1984). They may be correct. Two years ago the Supreme Court emphasized the breadth of Chevron, holding that it applied even to statutory provisions that could be considered jurisdictional. It wrote:
City of Arlington v. FCC, ___ U.S. ___, 133 S.Ct. 1863, 1868, ___ L.Ed.2d ___ (2013) (citation and internal quotation marks omitted). The Court noted that "[o]ne of [its] opinions explicitly says that no exception exists to the normal deferential standard of review for jurisdictional or legal questions concerning the coverage of an Act." Id. at 1871 (brackets and internal quotation marks omitted). With regard to preemption, the Court wrote, "We have even deferred to the FCC's assertion that its broad regulatory authority extends to pre-empting conflicting state rules." Id. "And," said the Court, "we have applied Chevron where concerns about agency self-aggrandizement are at their apogee: in cases where an agency's expansive construction of the extent of its own power would have wrought a fundamental change in the regulatory scheme." Id. at 1872. In response to the contention that Chevron deference was encroaching on matters of traditional local concern, the Court said, "[T]his case has nothing to do with federalism. [The applicable provision of the Telecommunications Act] explicitly supplants state authority by requiring zoning authorities to render a decision `within a reasonable period of time,' and the meaning of that phrase is indisputably a question of federal law." Id. at 1873. Rather, "[t]his is, at bottom, a debate not about whether the States will be allowed to do their own thing, but about whether it will be the [agency] or the federal courts that draw the lines to which they must hew." 133
Id. at 1874-75 (internal quotation marks omitted).
Strong stuff. One could easily infer from this language that Chevron applies to an agency interpretation of a preemption provision in a statute it administers. And, indeed, the Court has applied Chevron in just that situation. See Cuomo v. Clearing House Ass'n, 557 U.S. 519, 525, 129 S.Ct. 2710, 174 L.Ed.2d 464 (2009) (but finding agency's construction improper because statute's ambiguity did not stretch so far). Given the ambiguity in § 8902(m)(1), application of Chevron deference would require us to adopt OPM's reasonable view.
On the other hand, Arlington made no mention of the Court's repeated statements in recent years that it will merely give some weight to an agency's view on preemption,
555 U.S. at 577, 129 S.Ct. 1187 (citation and internal quotation marks omitted). As the agency that has negotiated FEHBA contracts for federal employees for years, OPM has deep knowledge of the impact and interrelationships of contractual provisions. Its longstanding and persuasively explained view that subrogation and reimbursement provisions are directly tied to employee health benefits and advance the congressional purposes served by § 8902(m)(1) is, in our view, of sufficient weight to persuade us to agree with its conclusion regarding preemption.
Ms. Helfrich contends that the district court's ruling implicates serious constitutional concerns because the Supremacy Clause does not permit contractual terms to preempt state laws, as § 8902(m)(1) provides. We are skeptical of this argument. The effect of the contractual provision here is no greater than the effect of the design specification in the contract in Boyle, where the Supreme Court held that the specification could override state tort law. See 487 U.S. at 512-13, 108 S.Ct. 2510. And we note that then-Circuit Judge Sotomayor said in the Second Circuit opinion in McVeigh that the provision could be construed to avoid the constitutional problem. See 396 F.3d at 144-45 ("[W]e can reasonably construe § 8902(m)(1) as requiring that, in cases involving the `terms of any contract under [FEHBA] which relate to the nature, provision, or extent of coverage or benefits,' federal law' shall supersede and preempt any State or local law, or any regulation issued thereunder, which relates to health insurance or plans.' 5 U.S.C. § 8902(m)(1). . . . The federal law preempting state law may be federal common law or the FEHBA statute provisions themselves, but it must be law—not contract terms."). In any event, because Ms. Helfrich did not raise this argument below and has not argued for plain-error review on appeal, we need not address it. See Richison v. Ernest Grp., Inc., 634 F.3d 1123, 1130-31 (10th Cir.2011). Ms. Helfrich says that she did not forfeit the argument because "[i]t is the district court's interpretation of § 8902(m)(1) that pits the text of FEHBA's preemption provision against the Supremacy Clause," so the constitutionality of the provision "only arose when the district court rejected the narrow interpretation urged . . . below." Aplt. Reply Br. at 25 n. 8. We disagree. When Blue Cross argued below that § 8902(m)(1) preempted the Kansas antisubrogation regulation, Ms. Helfrich had the opportunity to argue that § 8902(m)(1) was unconstitutional. There was no need to wait for the district court's interpretation. A party with two possible arguments to support its position cannot hold one in reserve and raise it on appeal only after losing on the other. See Price v. Wolford, D.O., 608 F.3d 698, 706 (10th Cir.2010) ("A party must make its arguments before the court rules. It cannot keep an arrow in its quiver in reserve, for use in case the judge says at the end of the contest that all the expended arrows missed the mark.").
For the foregoing reasons, we AFFIRM the judgment of the district court.
LUCERO, J., concurring.
I join the majority as to part II.B. I write separately to express my disagreement
The majority primarily rests its analysis on Boyle v. United Technologies Corp., 487 U.S. 500, 108 S.Ct. 2510, 101 L.Ed.2d 442 (1988). Under Boyle, federal law preempts state law if: (1) the area of law concerns uniquely federal interests; and (2) "a significant conflict exists between an identifiable federal policy or interest and the operation of state law, or the application of state law would frustrate specific objectives of federal legislation." Id. at 504-505, 507, 108 S.Ct. 2510 (citations omitted). Because I agree that FEHB contract terms present uniquely federal interests, the relevant question concerns Boyle's second prong, the "significant conflict" requirement.
A significant conflict with a federal interest exists if a claim is based on "the exercise or performance or the failure to exercise or perform a discretionary function or duty on the part of a federal agency or an employee of the Government." Id. at 511, 108 S.Ct. 2510 (quotation omitted). This rule stems from a provision of the Federal Tort Claims Act preserving government immunity against claims implicating agency discretion. Id. (citing 28 U.S.C. § 2680(a)). The purpose of that provision was to "prevent judicial `second-guessing' of legislative and administrative decisions . . . through the medium of an action in tort." United States v. S.A. Empresa de Viacao Aerea Rio Grandense (Varig Airlines), 467 U.S. 797, 814, 104 S.Ct. 2755, 81 L.Ed.2d 660 (1984) (emphasis added).
Extending the rule to a contract claim unmoors it from its purpose. Declining to extend the rule to actions in contracts is consistent with Boyle, where the court essentially granted § 2680(a) tort immunity to government contractors. See Boyle, 487 U.S. at 530, 108 S.Ct. 2510 (Brennan, J., dissenting) (stating that the decision is "premised on the proposition that any tort liability indirectly absorbed by the Government so burdens governmental functions as to compel us to act when Congress has not" (emphasis added)). Because the test Boyle enunciated is limited to actions in tort, I would not apply it to the contract claim in this case.
Moreover, even if we were to apply the Boyle test to a contract claim, the majority does not properly engage the test's second prong. The majority opinion does not define "significant conflict"; instead it spends several pages fortifying its conclusions that the federal interest in this case—the government's desire for system-wide uniformity and cost control—is significant, and that the conflict with state law is "stark." (Majority Op. 1099.) But Boyle rejected the proposition that a "stark" conflict with state law is sufficient to support preemption. Boyle, 487 U.S. at 509, 108 S.Ct. 2510 (even if state law is "precisely contrary to the duty imposed by the Government contract . . ., it would be unreasonable to say that there is always a significant conflict between the state law and a federal policy or interest"). The majority ignores this aspect of Boyle and instead reads the case as affirming that "a state regulation that directly conflicts with federal interests must be displaced." (Majority Op. 1103.)
I cannot agree. A "significant conflict" must arise from an act based on federal agency discretion. Boyle, 487 U.S. at 511, 108 S.Ct. 2510. Courts have struggled to
To understand the minimal importance of any discretion exercised in this case, it is instructive to consider the impact of subrogation (recovery from a third party) and reimbursement (recovery directly from the insured) on the asserted goals of uniformity and cost. The federal government's interest in uniformity is undermined if FEHB contracts do not require insurers to pursue reimbursement or to recover under subrogation. But the contract at issue grants the insurer a significant role in pursuing both remedies. It provides that the insurer must make a "reasonable effort to seek recovery of amounts to which it is entitled to recover [through subrogation] in cases which are brought to its attention." But, the insurer "shall not be required to recover any amounts from any [third party]" under subrogation. And if, as in this case, the insurer seeks reimbursement directly from the insured federal employee, the contract permits—but does not require—the insurer to seek recovery, contrary to the majority's reading.
The amount of cost-savings afforded by subrogation and reimbursement likewise suggests that the government interest is not significant. Across all states (most of which allow subrogation clauses), total subrogation recoveries amount to approximately
To conclude that the government interests in the case at bar deserve much weight, the majority analogizes FEHB insurers to the military contractors in Boyle, and observes that it makes little sense to insulate the government against liability where it produces equipment directly but not where it contracts for production. (Majority Op. 1100-01.) This analogy merely raises the question: would agency discretion shield the government from financial liability if the government issued insurance directly, and not through private insurers? Not under § 2680(a) because the claim does not sound in tort. And even if it did, the impact of allowing subrogation terms in FEHB contracts does not rise to the level of import of the decisions at issue in Boyle.
The majority also errs in its attempt to distinguish O'Melveny & Myers v. FDIC, 512 U.S. 79, 114 S.Ct. 2048, 129 L.Ed.2d 67 (1994). In O'Melveny the Court concluded that the government's general desire to avoid foregoing any money that might accrue to a federal fund was insufficient to support preemption without some limiting principle. Id. at 88, 114 S.Ct. 2048. The majority states that FEHB reimbursement provisions are "limited to recovering funds to prevent the boon of double recoveries for some enrollees." (Majority Op. 1102.) But, if this is the limiting principle, it has no teeth. The contract terms are not limited to those cases involving double-recovery. To the contrary, the official statement of benefits expressly provides that the insurer may recover "even if [the insured] is not `made whole' for all of [her] damages in the recoveries that [she] receive[s]." Helfrich alleges that the recovery from BCBS and from the offending driver's insurance together left $30,000 of her medical bills unaddressed. Accepting this well-pled allegation as true and construing it in the light most favorable to the plaintiff, Estes v. Wyoming Dep't of Transp., 302 F.3d 1200, 1203 (10th Cir. 2002), Helfrich did not receive a double-recovery. She did not even cover her costs. The reimbursement provisions are over-inclusive, as they allow more than just double recoveries, and under-inclusive, because insurers may decide not to collect even if the insured did receive a double-recovery. To the extent that preventing double-recovery is a limiting principle, it has no application in this case.
The majority's reasoning would exempt federal contracts from the contours of state law anytime the government finds that law economically inconvenient. We should not grant such broad authority to federal agencies. Instead, we should limit our preemption analysis to the relevant statute and the agency's implementing regulations. For these reasons, I do not join the majority's federal common law discussion.