CHRISTINA REISS, Chief District Judge.
On April 9, 2015, the court heard oral argument on Plaintiff Alan Lyle Howe, Jr.'s motion for a preliminary injunction (Doc. 2) and took it under advisement. Pursuant to Fed. R. Civ. P. 12(b)(1) and Fed. R. Civ. P. 12(b)(6), Defendants
In his four count Verified Complaint, Plaintiff seeks declaratory and injunctive relief arising out of the segregation of a portion of his health insurance premiums to cover non-federally funded ("NFF") abortion services as required by the Affordable Care Act (the "ACA"), 42 U.S.C. § 18023(b)(2). He alleges that forcing him to pay for NFF abortion services is contrary to his genuinely held religious beliefs, violates his constitutional rights, and fails to reflect accommodations to which he is entitled.
In Count I, Plaintiff alleges that the Federal Defendants have violated the federal Religious Freedom Restoration Act (the "RFRA"), 42 U.S.C. § 2000bb-1, because they have failed to offer an accommodation for a substantial burden on his religious beliefs. In Count II, he alleges that the State Defendants violated the Free Exercise Clause in Chapter 1, Article 3 of the Vermont Constitution on the same basis. In Count III, Plaintiff alleges a parallel claim against all Defendants under the Free Exercise Clause of the First Amendment to the U.S. Constitution. In Count IV, Plaintiff alleges that Defendants infringed upon his right to receive information regarding NFF abortion services coverage in violation of the Free Speech Clause to the First Amendment of the U.S. Constitution.
Plaintiff seeks a preliminary injunction only with regard to his RFRA and Free Exercise claims and only against the Federal Defendants and State Defendant Commissioner Constantino. Defendants oppose Plaintiff's request for preliminary injunctive relief, arguing, among other things, that Plaintiff lacks standing to seek relief that can only be provided by third party health insurers who are not before the court.
Defendants' motions to dismiss seek dismissal of all claims against them on a variety of grounds including lack of subject matter jurisdiction, standing, ripeness, failure to state a claim, and sovereign immunity. Plaintiff opposes dismissal.
Plaintiff is represented by M. Casey Mattox, Esq., Michael J. Tierney, Esq., and Steven H. Aden, Esq. The Federal Defendants are represented by Assistant United States Attorney Caroline L. Wolverton and Assistant United States Attorney Nikolas P. Kerest. The State Defendants are represented by Vermont Solicitor General Bridget C. Asay and Vermont Assistant Attorney General Jon T. Alexander.
Plaintiff works part-time and is not entitled to health insurance from his employer. He is also not entitled to any form of public assistance to defray his healthcare costs. He avers that he "is a Christian and believes in the sanctity of human life from the point of conception." (Doc. 1 at 6, ¶ 19.) He further avers that he "is strongly opposed to paying for the destruction of human life by others through insurance coverage for elective abortion." Id. Plaintiff has no dependents and thus no possibility of ever using insurance coverage for abortion services. Defendants do not contest whether Plaintiff's religious beliefs are genuinely held.
The ACA requires non-exempt individuals
For non-exempt individuals, Congress has authorized the states to establish their own health insurance exchanges ("Exchanges") through which state residents may purchase health insurance from insurers that have agreed to participate in the state's Exchange. See 42 U.S.C. § 18041(b). In Vermont, VHC is the Exchange. As an Exchange, VHC certifies that the health insurance offered to Vermonters provides coverage for certain essential health benefits; determines plan enrollment eligibility; calculates the value of certain subsidies; and certifies exemptions from the tax penalty. Id. §§ 18021(a)(1)(B); 18031(d)(4). Commissioner Constantino, as Commissioner of VHA, is responsible for the administration of VHC.
In the fall of 2013, Plaintiff was advised that, due to the ACA, his health insurance plan was being cancelled and he would need to enroll in a plan through VHC. For the 2014 plan year, Plaintiff selected the Blue Cross and Blue Shield of Vermont Blue Rewards Non-Standard Silver plan (the "BCBSVT plan") through VHC. Plaintiff alleges that he examined the Summary of Benefits and Exclusions for the BCBSVT plan and erroneously concluded that it did not offer coverage for NFF abortion services. The State Defendants contest this allegation and proffer evidence that Plaintiff had access to the notification required by law that the BCBSVT plan offered coverage for NFF abortion services.
Under the ACA, an insurer offering a health insurance plan has a "[v]oluntary choice [to provide] coverage of abortion services[.]" 42 U.S.C. § 18023(b)(1). The ACA thus neither requires health insurers to provide coverage for NFF abortion services, nor prohibits them from doing so. A state may enact legislation that "prohibit[s] abortion coverage" in qualified health plans ("QHPs") offered by a state's Exchange. See 42 U.S.C. § 18023(a). Vermont's General Assembly has chosen not to do so.
Pursuant to the Hyde Amendment, federal funds may not be used to pay for abortion services except in the case of rape, incest, or danger to the life of the mother.
Plaintiff paid his first monthly premium for the BCBSVT plan on March 21, 2014. Because of the amount of his income, Plaintiff was entitled to federal and state subsidies totaling $376 per month to cover a monthly premium of $395.
In November 2014, Plaintiff alleges that he became aware that the BCBSVT plan provided coverage for NFF abortion services and segregated a portion of Plaintiff's premium to pay for those services in accordance with the ACA's segregation requirement. The State Defendants contest this claim and proffer evidence that Plaintiff ceased paying his health insurance premiums prior to the November 2014 date. In addition, the State Defendants proffer evidence that Plaintiff's health insurance plan prior to the ACA also provided coverage for NFF abortion services. In light of these contested facts, Plaintiff agrees that the court cannot rely on Plaintiff's assertion that he cancelled his health insurance coverage because of his genuinely held religious beliefs. Instead, the court can only rely on Plaintiff's representation that he seeks to obtain health insurance now and in the future that either does not provide coverage for NFF abortion services or that does not require a separate payment which is segregated and used for NFF abortion services.
Every health insurance plan offered on VHC at this time provides coverage for NFF abortion services. Moreover, Defendants represent that every health insurance plan available in Vermont from a source other than VHC also provides coverage for NFF abortion services.
The ACA authorizes OPM through its Director to contract with health insurers in order to offer at least two multi-state QHPs through each state's Exchange. 42 U.S.C. § 18054(a)(1). The ACA provides that at least one of these multi-state QHPs must not provide coverage for NFF abortion services. Id. § 18054(a)(6). A health insurer cannot be compelled to offer a multi-state QHP and, at present, no health insurer has contracted with OPM to offer a multi-state QHP in Vermont.
If Plaintiff does not comply with the individual mandate, he will be responsible for the tax penalty no earlier than April 18, 2016 when his 2015 federal tax return must be filed. In his Verified Complaint, Plaintiff makes no allegation that he needs to arrange his finances now in order to pay the tax penalty when and if it becomes due.
The Federal Defendants have stipulated that they "are willing to forego enforcement of 42 U.S.C. § 18023(b)(2)'s segregation requirement as to an insurer who agrees to insure Mr. Howe and not segregate any portion of his payment for the NFF abortion account, so long as no plan offered through [VHC] excludes NFF abortion coverage." (Doc. 40 at 4.) The Federal Defendants further represent that they tried to persuade the two health insurers that offer insurance coverage through VHC to create a plan for Plaintiff that does not provide coverage for NFF abortion services but were unsuccessful. Although these representations have no evidentiary value, they cast doubt on Plaintiff's argument that an injunction is likely to cause third party insurers, who are not subject to the injunction, to alter their behavior and provide Plaintiff with the health insurance he desires.
The State Defendants, in turn, have agreed to extend VHC's February 15, 2015 enrollment deadline and provide a special enrollment period for Plaintiff if the court rules in his favor. See Doc. 8 at 2, ¶ 4 ("Counsel for the Vermont Defendants represent that they will permit a special enrollment period after February 15, 2015, if needed to effectuate any order of this Court in Plaintiff's favor, and counsel for the federal Defendants represent that they will not oppose such action.").
In his motion for a preliminary injunction, Plaintiff requests the following relief:
(Doc. 2 at 2.) At oral argument, Plaintiff conceded that the court cannot compel third party insurers to provide health insurance that does not offer coverage for NFF abortion services. Accordingly, to the extent his motion contains such requests, they are withdrawn.
In his briefing, Plaintiff seeks to extend his request for injunctive relief to include an order that Defendants "pay for [his] health expenses in the short term while they work toward a more permanent solution" or "[a]t a bare minimum, Defendants can provide [him] the subsidies to which he would be entitled were he able to enroll in a plan through Vermont Health Connect." (Doc. 41 at 14.)
The Federal Defendants seek dismissal of all claims against them for lack of subject matter jurisdiction pursuant to Fed. R. Civ. P. 12(b)(1) and for failure to state a claim for which relief may be granted pursuant to Fed. R. Civ. P. 12(b)(6). The State Defendants seek dismissal of the claims against them on this same basis and assert Eleventh Amendment immunity as well.
"A case is properly dismissed for lack of subject matter jurisdiction under Rule 12(b)(1) when the district court lacks the statutory or constitutional power to adjudicate it." Makarova v. United States, 201 F.3d 110, 113 (2d Cir. 2000). "In resolving a motion for lack of subject matter jurisdiction under Rule 12(b)(1), a district court . . . may refer to evidence outside the pleadings." Id.
"A plaintiff asserting subject matter jurisdiction has the burden of proving by a preponderance of the evidence that it exists." Id. "[B]ecause jurisdiction must be shown affirmatively, courts do not draw inferences from the pleadings in favor of the petitioner." Lakhani v. U.S. Citizenship & Immigration Servs., 2013 WL 3829624, at *2 (D. Vt. July 23, 2013). "Determining subject matter jurisdiction is a `threshold inquiry,' and should be addressed prior to any consideration of the Complaint's substantive merits." Grundstein v. Vermont, 2011 WL 6291955, at *2 (D. Vt. Dec. 15, 2011) (quoting Arar v. Ashcroft, 532 F.3d 157, 168 (2d Cir. 2008)).
In deciding a motion to dismiss under Rule 12(b)(6) for failure to state a claim, a court assumes "all well-pleaded, nonconclusory factual allegations in the complaint to be true," Kiobel v. Royal Dutch Petroleum Co., 621 F.3d 111, 124 (2d Cir. 2010), and determines "whether they plausibly give rise to an entitlement to relief." Ashcroft v. Iqbal, 556 U.S. 662, 679 (2009). The court also draws "all reasonable inferences in the plaintiff's favor." Holmes v. Grubman, 568 F.3d 329, 335 (2d Cir. 2009) (internal quotation marks omitted). However, the court does not credit "legal conclusions" or "[t]hreadbare recitals of the elements of a cause of action, supported by mere conclusory statements." Iqbal, 556 U.S. at 678. To survive a motion to dismiss, a complaint must contain sufficient factual allegations "to raise a right to relief above the speculative level." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007).
Iqbal, 556 U.S. at 678 (citations and internal quotation marks omitted).
The district court's role "is merely to assess the legal feasibility of the complaint, not to assay the weight of the evidence which might be offered in support thereof." DiFolco v. MSNBC Cable L.L.C., 622 F.3d 104, 113 (2d Cir. 2010) (internal quotation marks omitted). In making this determination, the court therefore does not evaluate the credibility of the Plaintiff's factual allegations even if made under oath. See Wright v. MetroHealth Med. Ctr., 58 F.3d 1130, 1138 (6th Cir. 1995) ("In considering a motion under Fed. R. Civ. P. 12(b)(6), it is not the function of the court to weigh the evidence or evaluate the credibility of witnesses[.]") (citation omitted).
In the event that the court determines that one or all of Plaintiff's claims must be dismissed for lack of subject matter jurisdiction, Plaintiff's request for preliminary injunctive relief with regard to the dismissed claim will become moot. See Nat'l Athletic Trainers' Ass'n, Inc. v. U.S. Dep't of Health & Human Servs., 2005 WL 1923566, at *2 (N.D. Tex. Aug. 11, 2005), aff'd, 455 F.3d 500 (5th Cir. 2006) ("[A] court lacks the authority to provide injunctive relief once it has determined that it lacks jurisdiction over the underlying case."). A dismissal for failure to state a claim for which relief may be granted produces this same result. For those claims that are not dismissed, the court must analyze whether Plaintiff has established his entitlement to preliminary injunctive relief.
"A plaintiff seeking a preliminary injunction must establish that he is likely to succeed on the merits, that he is likely to suffer irreparable harm in the absence of preliminary relief, that the balance of equities tips in his favor, and that an injunction is in the public interest." Winter v. Nat. Res. Def. Council, Inc., 555 U.S. 7, 20 (2008); see also Mullins v. City of New York, 626 F.3d 47, 53 (2d Cir. 2010) (ruling that "when a party seeks an injunction that will affect governmental action taken in the public interest pursuant to a statutory or regulatory scheme, the plaintiff must typically show a likelihood of success on the merits—a serious question going to the merits is usually insufficient, even if the balance of hardships tips decidedly in the applicant's favor."). "A preliminary injunction is an extraordinary remedy never awarded as of right." Winter, 555 U.S. at 24.
Irreparable harm is "the single most important prerequisite for the issuance of a preliminary injunction[.]" Bell & Howell: Mamiya Co. v. Masel Supply Corp., 719 F.2d 42, 45 (2d Cir. 1983) (internal quotation marks omitted); see also Citigroup Global Mkts., Inc. v. VCG Special Opportunities Master Fund Ltd., 598 F.3d 30, 37 n.6 (2d Cir. 2010) (noting that "Winter reiterates the majority position of the circuits, including [the Second Circuit], that a showing of irreparable harm is fundamental to any grant of injunctive relief'). Plaintiff must therefore proffer persuasive evidence that he will suffer irreparable harm "if he . . . loses on the preliminary injunction but ultimately prevails on the merits, [with] particular attention to whether the `remedies available at law, such as monetary damages, are inadequate to compensate for that injury.'" Salinger v. Colting, 607 F.3d 68, 80 (2d Cir. 2010) (quoting eBay Inc. v. MercExchange, L.L.C., 547 U.S. 388, 391 (2006)). Plaintiff must also establish that his alleged harm is not self-inflicted. See Lee v. Christian Coal. of Am., Inc., 160 F.Supp.2d 14, 33 (D.D.C. 2001) ("The case law is well-settled that `[a] preliminary injunction movant does not satisfy the irreparable harm criterion when the alleged harm is self-inflicted.'") (citation omitted); 11A Charles A. Wright, Federal Practice and Procedure§ 2948.1 (3d ed. 1998) ("[A] party may not satisfy the irreparable harm requirement if the harm complained of is self-inflicted."). Finally, in seeking preliminary injunctive relief, Plaintiff cannot rest on mere arguments; he must proffer admissible evidence that clearly demonstrates his entitlement to the requested relief. See 1-800-411-Pain Referral Serv., LLC v. Otto, 744 F.3d 1045, 1063 (8th Cir. 2014) (noting that, to obtain a preliminary injunction, "the record must contain more than allegations; it must contain facts"). If Plaintiff's evidence is contested, the court cannot consider it in adjudicating the motion unless an evidentiary hearing is held. See Kern v. Clark, 331 F.3d 9, 12 (2d Cir. 2003) ("`The existence of factual disputes necessitates an evidentiary hearing . . . before a motion for a preliminary injunction may be decided.'") (alteration in original) (quoting Commodity Futures Trading Comm'n v. Incomco, Inc., 649 F.2d 128, 131 (2d Cir. 1981)).
In this case, the parties waived their right to an evidentiary hearing regarding Plaintiff's motion for a preliminary injunction. Because of that waiver, they agree that the court must rely only on undisputed evidence in adjudicating the motion.
In Count II of his Verified Complaint, Plaintiff alleges that the State Defendants violated Chapter I, Article III of the Vermont Constitution through their interpretation, application, and enforcement of the ACA. The State Defendants argue that the court lacks subject matter jurisdiction to hear a state constitutional claim against state defendants in federal court.
Fleet Bank, Nat'l Ass'n v. Burke, 160 F.3d 883, 891 (2d Cir. 1998). Plaintiff's requests for declaratory relief based on state law raise these same concerns. Permitting "a federal court [to] instruct[] state officials on how to conform their conduct to state law . . . conflicts directly with the principles of federalism that underlie the Eleventh Amendment." Pennhurst State Sch. & Hosp., 465 U.S. at 106. As a result, in federal court, "[s]uits against state officers . . . can only seek prospective injunctive or declaratory relief for violations of federal law." Davis v. Pallito, 2011 WL 4443026, at *6 (D. Vt. June 16, 2011), report and recommendation adopted, 2011 WL 4443008 (D. Vt. Sept. 22, 2011).
Plaintiff bears the burden of establishing subject matter jurisdiction for each of his claims. Makarova, 201 F.3d at 113. Because he fails to establish that this court is authorized to adjudicate his state constitutional claims against the State Defendants, see Pennhurst State Sch. & Hosp., 465 U.S. at 106, Count II must be DISMISSED pursuant to Fed. R. Civ. P. 12(b)(1) for lack of subject matter jurisdiction.
In Counts II, III, and IV, Plaintiff alleges that VHA and VHC violated both his state and federal constitutional rights by burdening Plaintiff's free exercise of his religion and by allegedly failing to disclose that all of the health insurance plans available from VHC offer coverage for NFF abortion services. VHA and VHC seek dismissal of these claims on the grounds of Eleventh Amendment immunity. The court has previously dismissed Count II and thus only Plaintiff's Free Exercise and Free Speech claims against VHA and VHC remain.
VHA is a department within the Vermont Agency of Human Services, see 3 V.S.A. §§ 212(24); 3088, and VHC is administered by VHA, see 33 V.S.A. § 1803(a). Plaintiff does not dispute that both of these State Defendants are arms of the State of Vermont.
"Because of the Eleventh Amendment, States may not be sued in federal court unless they consent to it in unequivocal terms or unless Congress, pursuant to a valid exercise of power, unequivocally expresses its intent to abrogate the immunity." Green v. Mansour, 474 U.S. 64, 68 (1985); see also Va. Office for Prot. & Advocacy v. Stewart, 131 S.Ct. 1632, 1637 (2011) ("Sovereign immunity is the privilege of the sovereign not to be sued without its consent."); Sossamon v. Texas, 131 S.Ct. 1651, 1657-58 (2011) (explaining that "federal jurisdiction over suits against unconsenting States was not contemplated by the Constitution when establishing the judicial power of the United States.") (internal quotation marks omitted).
"[T]he State of Vermont has expressly preserved its sovereign immunity under the Eleventh Amendment." Collette v. Vermont, 2010 WL 186173, at *2 (D. Vt. Jan. 13, 2010); see also 12 V.S.A. § 5601(g) ("Nothing in this chapter waives the rights of the State under the Eleventh Amendment of the United States Constitution."). "[A]bsent waiver or valid abrogation, federal courts may not entertain a private person's suit against a State." Stewart, 131 S. Ct. at 1638.
Because Plaintiff has failed to allege any exception to Eleventh Amendment immunity for his claims against VHA and VHC, those defendants are entitled to dismissal of the claims against them. See Madden v. Vt. Sup. Ct., 236 F. App'x 717, 718 (2d Cir. 2007) ("The Eleventh Amendment precludes [a plaintiff] from bringing suit against the state or state agencies, because it deprives the federal courts of subject matter jurisdiction over any action asserted by an individual against a state regardless of the nature of the relief sought."). The State Defendants' motion to dismiss all claims against VHA and VHC is therefore GRANTED and VHA and VHC are hereby DISMISSED from this lawsuit.
In Count One of his Verified Complaint, Plaintiff alleges that the Federal Defendants
Plaintiff neither challenges the constitutionality of the ACA nor explains how the Federal Defendants can be credited for "enacting" it. The Supreme Court has instructed that "courts must look to the underlying policies or legislative intent in order to draw a manageable line between those causal changes that may make an actor responsible for an effect and those that do not." Metro. Edison Co. v. People Against Nuclear Energy, 460 U.S. 766, 774 n.7 (1983). Although the Federal Defendants have certain duties and responsibilities under the ACA, they are not responsible for its enactment.
Plaintiff also does not allege that the Federal Defendants' interpretation of the ACA is erroneous or otherwise inconsistent with the plain language of the ACA itself. As a result, Plaintiff's conclusory allegation that RFRA is violated based on the Federal Defendants' "interpretation" of the ACA does not give rise to a plausible claim for relief. See Renal Physicians Ass'n v. U.S. Dep't ofHealth & Human Servs., 489 F.3d 1267, 1278 (D.C. Cir. 2007) (ruling that "although less is required to survive a motion to dismiss than a motion for summary judgment, [precedent] makes clear that a bald allegation of standing is not enough to survive even a motion to dismiss where neither the factual allegations nor their logic establish redressability"). The court therefore confines its analysis to Plaintiff's RFRA claim that the Federal Defendants' enforcement of the ACA imposes a substantial burden on Plaintiff's free exercise of his religion.
"Congress enacted RFRA . . . in order to provide very broad protection for religious liberty." Burwell v. Hobby Lobby Stores, Inc., 134 S.Ct. 2751, 2760 (2014). Under RFRA, the "Government shall not substantially burden a person's exercise of religion even if the burden results from a rule of general applicability[,]" unless the Government "demonstrates that application of the burden to the person — (1) is in furtherance of a compelling governmental interest; and (2) is the least restrictive means of furthering that compelling governmental interest." 42 U.S.C. § 2000bb-1(b). "[A] substantial burden exists where the [government] put[s] substantial pressure on an adherent to modify his behavior and to violate his beliefs." Newdow v. Peterson, 753 F.3d 105, 109 (2d Cir. 2014), cert. denied, 135 S.Ct. 1008 (2015) (internal quotation marks omitted).
For purposes of RFRA, "a law that `operates so as to make the practice of . . . religious beliefs more expensive' in the context of business activities imposes a burden on the exercise of religion." Hobby Lobby Stores, Inc., 134 S. Ct. at 2770 (citation omitted). "[I]f there are other, reasonable ways to achieve [the government's] goals with a lesser burden on constitutionally protected activity, [the government] may not choose the way of greater interference. If it acts at all, it must choose `less drastic means.'" Johnson v. City of Cincinnati, 310 F.3d 484, 503 (6th Cir. 2002) (quoting Dunn v. Blumstein, 405 U.S. 330, 343 (1971)). "The least-restrictive-means standard is exceptionally demanding[.]" Hobby Lobby Stores, Inc., 134 S. Ct. at 2780.
In analyzing Plaintiff's ACA enforcement claims, the court is not bound by conclusory allegations regarding the impact of a statutory or regulatory scheme:
Geneva Coll. v. Sec. of Health & Human Servs., 778 F.3d 422, 436 (3d Cir. 2015) (citation omitted) (holding plaintiffs failed to establish that compliance with religious employer "accommodation" provision of ACA's contraceptive mandate imposed substantial burden on their free exercise of religion). The court must therefore determine if the ACA actually impacts Plaintiff's free exercise of religion before it can consider Plaintiff's proposed RFRA accommodations.
As a threshold issue, the Federal Defendants assert that they are entitled to dismissal of Count I because Plaintiff lacks standing to assert a RFRA claim based upon the independent choices of third parties not before the court. "Article III of the Constitution limits federal courts' jurisdiction to certain Cases and Controversies. . . . One element of the case-or-controversy requirement is that plaintiffs must establish that they have standing to sue." Clapper v. Amnesty Int'l USA, 133 S.Ct. 1138, 1146 (2013) (internal quotation marks and citation omitted). The Supreme Court has held that the "irreducible constitutional minimum of standing" requires that "the plaintiff must have suffered an `injury in fact[,]'" "there must be a causal connection between the injury and the conduct complained of[,]" and "it must be `likely,' as opposed to merely speculative,' that the injury will be `redressed by a favorable decision.'" Lujan v. Deft. of Wildlife, 504 U.S. 555, 560-61 (1992) (internal citation omitted). "The party invoking federal jurisdiction bears the burden of establishing these elements." Id. at 561.
When "[t]he existence of one or more of the essential elements of standing depends on the unfettered choices made by independent actors not before the courts[,] . . . it becomes the burden of the plaintiff to adduce facts showing that those choices have been or will be made in such manner as to produce causation and permit redressability of injury." Id. at 562 (internal quotation marks omitted). In other words, where the actions of a third party are at issue, even for pleading purposes, "bald allegation[s]" are not enough; instead, a plaintiff must allege facts "sufficient to demonstrate a substantial likelihood that the third party directly injuring the plaintiff would cease doing so as a result of the relief the plaintiff sought." Renal Physicians Ass'n, 489 F.3d at 1275; see also Lujan, 504 U.S. at 561 (noting that the elements of standing are "not mere pleading requirements but rather an indispensable part of the plaintiff's case").
The Federal Defendants argue that they cannot be deemed to have imposed any burden, much less a substantial burden, on Plaintiff's religious beliefs because any such burden arises out of the decisions of third party health insurers to: (1) participate in VHC, which is Vermont's sole Exchange; (2) offer coverage for NFF abortion services, which they are lawfully entitled to offer; (3) comply with the ACA's separate payment and segregation requirements, which, in turn, are required by the Hyde Amendment; and (4) offer a multi-state QHP that does not provide coverage for NFF abortion services.
In this case, the Verified Complaint contains no facts indicating that the Federal Defendants have directed, participated in, or encouraged the third party health insurers' decisions to offer coverage for NFF abortion services. Bare assertions that the Federal Defendants are somehow responsible will not suffice. See id. at 64, 66 (holding "absent government coercion or significant government encouragement . . . the federal government may not be held responsible for a measure taken by a private actor" and extending RFRA to federal agencies on this basis is not justified). Similarly, Plaintiff alleges no facts that would support a conclusion that third party health insurers would cease inflicting the alleged harm on Plaintiff's religious beliefs if Plaintiff's requests for declaratory and injunctive relief were granted.
Plaintiff's reliance on the ACA's separate payment and segregation requirements for his RFRA claims also targets third party actions. The ACA's separate payment requirement is directed not to Plaintiff, as a policyholder, but to third party health insurers who collect premiums and who must then, consistent with the Hyde Amendment, segregate a portion of them in an allocation account to pay for NFF abortion services. See 42 U.S.C. § 18023(b)(2)(B)(i). Relieving Plaintiff of an obligation to make a separate payment (which is not imposed on him by the ACA) will thus have no bearing on whether a third party health insurer segregates a portion of Plaintiff's remaining premium for NFF abortion services. Plaintiff does not dispute that the ACA's separate payment and segregation requirements are consistent with his religious beliefs. The ACA therefore "already takes into account beliefs like those of [the plaintiff] and accommodates them." Geneva Coll., 778 F.3d at 441. "The accommodation in this case consists in the [federal government] . . . washing its hands of any involvement in [NFF abortion services coverage], and the insurer . . . taking up the slack [consistent with the restrictions] of federal law." Id. (citation omitted).
The vast majority of Plaintiff's RFRA claims therefore arise out of the decisions of third parties, not the regulatory scheme set forth in the ACA. "[T]he case law clearly draws a distinction between what the law may impose on a person over religious objections, and what it permits or requires a third party to do." Id. "RFRA does not grant [Plaintiff] a religious veto against plan providers' compliance with [federal] regulations, nor the right to enlist the government to effectuate such a religious veto against legally required conduct of third parties." Id. at 439 (quoting Priests for Life v. U.S. Dep't of Health & Human Servs., 772 F.3d 229, 251 (D.C. Cir. 2014)). Plaintiff is thus not entitled to declaratory or injunctive relief that would compel the Federal Defendants to attempt to compel third party health insurers to alter their practices because RFRA does not permit Plaintiff"to impose a restraint on another's action based on the claim that the action is religiously abhorrent." Id. at 441.
To the extent Plaintiff asserts a RFRA claim based upon third party health insurers' decision to offer coverage for NFF abortion services; to collect a separate payment for this coverage; and to segregate it in their allocation accounts, Plaintiff's RFRA claims are hereby DISMISSED for lack of standing. See Lexmark Int'I, Inc. v. Static Control Components, Inc., 134 S.Ct. 1377, 1390 (2014) (observing that in a standing analysis, "the proximate-cause requirement generally bars suits for alleged harm that is too remote from the defendant's unlawful conduct. That is ordinarily the case if the harm is purely derivative of misfortunes visited upon a third person by the defendant's acts") (internal quotation marks omitted).
Plaintiff's remaining RFRA claims are based on regulatory decisions for which the Federal Defendants may plausibly be deemed responsible. Plaintiff alleges that the Federal Defendants are empowered to enforce the individual mandate which, in turn, places a substantial burden on his religious beliefs because, in Vermont, it forces him to obtain health insurance coverage that includes NFF abortion services. By exempting Plaintiff from the individual mandate, the Federal Defendants may alleviate at least some of Plaintiff's harm. Under RFRA, the absence of a specific exemption under the ACA directed to Plaintiff's religious beliefs is not dispositive. See Hobby Lobby Stores, Inc., 134 S. Ct. at 2781 (noting that under RFRA, the government may be required to create entirely new programs and modify existing ones in order to accommodate genuinely held religious beliefs); see also id. at 2787 (Ginsburg, J., dissenting) ("In a decision of startling breadth, the Court holds that [a person] can opt out of any law (saving only tax laws) they judge incompatible with their sincerely held religious beliefs.").
Plaintiff, however, has not applied for an exemption from the individual mandate which is a condition precedent to his obtaining one. See 45 C.F.R. § 155.605(b) (empowering administrators of a state exchange to "provide a certificate of exemption only for the calendar year in which an applicant submitted an application for such exemption."). In his Verified Complaint, Plaintiff asserts under oath that he "does not qualify for any exemption from the mandate," (Doc. 1 at 12, ¶ 45), he concedes that an exemption would not provide him with the health insurance he seeks, (Doc. 1 at 16, ¶ 64), and he does not request an exemption in his prayer for relief. (Doc. 1 at 23.) He thus cannot complain that the Federal Defendants' enforcement of the individual mandate and the tax penalty are presently burdening his religious beliefs because they clearly are not. To the contrary, it is undisputed that the Federal Defendants have taken no enforcement action against Plaintiff.
Moreover, the Federal Defendants do not foreclose the possibility of Plaintiff obtaining an exemption from the individual mandate should he apply for one. See Doc. 43 at 11 (observing that no tax penalty will accumulate if "Plaintiff can avail himself of an exemption under Section 5000A."). As a result, the court is left to guess at both whether Plaintiff intends to apply for an exemption and whether one will be granted. Plaintiff's RFRA claims based upon the Federal Defendants' enforcement of the individual mandate and the tax penalty are thus not ripe for adjudication. See Connecticut v. Duncan, 612 F.3d 107, 114 (2d Cir. 2010) ("Prudential ripeness is . . . a tool that courts may use to enhance the accuracy of their decisions and to avoid becoming embroiled in adjudications that may later turn out to be unnecessary or may require premature examination of, especially, constitutional issues that time may make easier or less controversial.") (internal quotation marks omitted); see also N.J. Physicians, Inc. v. Obama, 653 F.3d 234, 239 (3d Cir. 2011) (concluding that, where complaint was silent as to whether plaintiff was entitled to an exemption from individual mandate, allegations did not establish an "imminent" injury that is "concrete and particularized"); Scheibe v. Nat'l Bd. of Med. Exam'rs, 424 F.Supp.2d 1140, 1145 (W.D. Wis. 2006) (finding the "plaintiff is not in immediate danger of sustaining a direct injury" because "he has not registered with a state medical board or the federation to sit for [a test] and he has not presented any evidence showing that he intends to do so").
Plaintiff fares no better with his contention that, as an accommodation under RFRA, the Federal Defendants should be directed to pay for Plaintiff's healthcare expenses or to pay directly to Plaintiff the state and federal subsidies for which he qualifies so that he can use that money to defray his healthcare costs.
Plaintiff's reliance on Thomas v. Review Bd. of Ind. Emp't Sec. Div., 450 U.S. 707 (1981) for a contrary proposition is misplaced. There, the Supreme Court held:
Id. at 717-18.
Here, in contrast, the Federal Defendants are not conditioning the availability of subsidies under the ACA on Plaintiff's willingness to forego his religious beliefs; they are offering those subsidies regardless of Plaintiff's religious beliefs. If a third party health insurer offers a health insurance plan that does not cover NFF abortion services, Plaintiff presumably will seek to use the subsidies to offset the cost of that insurance. If a third party health insurer declines to offer Plaintiff that option, a direct monetary payment to Plaintiff may provide modest assistance in paying for his healthcare needs, but it will have no impact on whether he is free to practice his religion. It is therefore the decision of third party insurers to provide coverage for NFF abortion services, not the availability of subsidies, that imposes a burden on Plaintiff's religious beliefs. A direct monetary payment to Plaintiff will thus fail to redress Plaintiff's alleged harm. See E.M. v. N.Y.C. Dep't of Educ., 758 F.3d 442, 450 (2d Cir. 2014) ("A plaintiff need not demonstrate with certainty that her injury will be cured by a favorable decision, but she must at least make a showing that there is a `substantial likelihood that the relief requested will redress the injury claimed.'") (quoting Duke Power Co. v. Carolina Envtl. Study Grp., Inc., 438 U.S. 59, 75 n.20 (1978)). Plaintiff's request for declaratory and injunctive relief seeking a direct payment to him of federal and state subsidies therefore fails to state a plausible claim for relief and must be DISMISSED. See Fed. R. Civ. P. 12(b)(6).
More persuasively, Plaintiff argues that the Federal Defendants may alleviate a burden on Plaintiff's religious beliefs by refraining from enforcement actions against a third party insurer who agrees not to adhere to the segregation requirement for health insurance offered to Plaintiff. Although this relief requires the cooperation of a third party, Plaintiff need not establish that an accommodation will fully redress his harm in order to be entitled to it. As the Eighth Circuit recently observed in conjunction with a RFRA claim:
Wieland v. U.S. Dep'y of Health & Human Servs., 2015 WL 4393572, at *3 (8th Cir. July 20, 2015) (quoting Bennett v. Spear, 520 U.S. 154, 168-69 (1997)).
The Federal Defendants argue that the court should nonetheless dismiss Plaintiff's RFRA claim in its entirety because they can establish that any burden on Plaintiff's religious beliefs is supported by a compelling governmental interest in providing universal health insurance while complying with the Hyde Amendment. They further argue that they have chosen the least restrictive means of furthering that interest. However, in order to state a plausible claim for relief, Plaintiff need not disprove the Federal Defendants' claims with regard to which they bear the burden of proof. See Mycone Dental Supply Co. v. Creative Nail Design, Inc., 2012 WL 3599368, at *5 (D. N.J. Aug. 17, 2012) (ruling "the plaintiff need not disprove defense theories at the motion to dismiss stage."). Instead, Plaintiff need only plausibly allege that the Federal Defendants' enforcement of certain provisions of the ACA imposes substantial burdens on his religious beliefs and that non-enforcement of those same provisions will afford Plaintiff some measure of relief. Plaintiff's request for a declaratory judgment that he is entitled to non-enforcement of the segregation requirement (and the separate payment) is therefore sufficiently plausible to avoid dismissal at this stage in the proceedings. See Glob. Network Commc'ns, Inc. v. City of New York, 458 F.3d 150, 155 (2d Cir. 2006) ("The purpose of Rule 12(b)(6) is to test, in a streamlined fashion, the formal sufficiency of the plaintiff's statement of a claim for relief without resolving a contest regarding its substantive merits.").
For the reasons stated, the court GRANTS IN PART and DENIES IN PART the Federal Defendants' motion to dismiss Plaintiff's RFRA claims. Plaintiff's RFRA claims as set forth in Count I are DISMISSED except for his request for a declaratory judgment that he is entitled to a religious accommodation under RFRA that will permit any health insurer from whom he obtains health insurance coverage to refrain from collecting a separate payment from him and complying with the segregation requirement under the ACA. Such relief will assist in ensuring that Plaintiff will not pay for NFF abortion services in contravention to his genuinely held religious beliefs.
In order to obtain preliminary injunctive relief with regard to his remaining RFRA claim, Plaintiff must establish that he will suffer irreparable harm before trial that is imminent, non-contingent, and non-speculative. See Kamerling v. Massanari, 295 F.3d 206, 214 (2d Cir. 2002) ("[I]rreparable harm must be shown to be actual and imminent, not remote or speculative."); see also Rodriguez ex rel. Rodriguez v. DeBuono, 175 F.3d 227, 235 (2d Cir. 1998), as amended (Mar. 23, 1999) ("For purposes of preliminary injunctions, . . . the harm must be so imminent as to be irreparable if a court waits until the end of trial to resolve the harm."). "Issuing a preliminary injunction based only on a possibility of irreparable harm is inconsistent with [the Court's] characterization of injunctive relief as an extraordinary remedy that may only be awarded upon a clear showing that the plaintiff is entitled to such relief." Winter, 555 U.S. at 22.
In this case, a preliminary injunction is not necessary in light of the Federal Defendants' agreement to refrain from enforcement of the segregation requirement (and thus the separate payment) for any insurer willing to offer Plaintiff health insurance coverage until health insurance without coverage for NFF abortion services becomes available. See Pan Am. World Airways, Inc. v. Flight 001, Inc., 2007 WL 2040588, at *6 (S.D.N.Y. July 13, 2007) ("Some district courts in the Second Circuit have held that defendant's voluntary cessation of activity affords no reason for denying a preliminary injunction. But I conclude that such a rule is at odds with the nature of a preliminary injunction, which is an extraordinary equitable remedy[.]") (internal citation and quotation marks omitted); see also Entergy Nuclear Vt. Yankee, LLC v. Shumlin, 2011 WL 2811317, at *2-3 (D. Vt. July 18, 2011) (noting a court may "decline[] to order short-term drastic and extraordinary injunctive relief' that would "have no operative effect on state actions before trial" and observing that a court is "in a better position to tailor injunctive relief, if it is warranted, as part of a final determination of the merits"). In the event the Federal Defendants withdraw this concession or refuse to make it permanent, nothing prevents Plaintiff from renewing his motion.
Plaintiff's motion for a preliminary injunction with regard to his remaining RFRA claim is therefore DENIED WITHOUT PREJUDICE.
In Counts III and IV of his Verified Complaint, Plaintiff seeks declaratory and injunctive relief against Commissioner Constantino arising out of his alleged violations of Plaintiff's rights under the Free Exercise and Free Speech clauses of the First Amendment to the U.S. Constitution. Because Commissioner Constantino is sued only in his official capacity, Plaintiff must establish that his claims fall within a narrow exception to the Eleventh Amendment, commonly referred to as the Ex parte Young doctrine.
"The landmark case of Ex parte Young . . . created an exception to th[e] general principle [of sovereign immunity] by asserting that a suit challenging the constitutionality of a state official's action in enforcing state law is not one against the State." Green, 474 U.S. at 68. "Young also held that the Eleventh Amendment does not prevent federal courts from granting prospective injunctive relief to prevent a continuing violation of federal law." Id. The courts have not interpreted the Ex parte Young doctrine expansively. See Children's Healthcare is a Legal Duty, Inc. v. Deters, 92 F.3d 1412, 1415 (6th Cir. 1996) ("Courts have not read Young expansively."); HealthNow N.Y., Inc. v. New York, 739 F.Supp.2d 286, 294 (W.D.N.Y. 2010), aff'd, 448 F. App'x 79 (2d Cir. 2011) (same).
To ensure that Plaintiff's request for injunctive relief is not actually a claim against a state in the guise of a claim against a state official, the court must examine Commissioner Constantino's connection to the federal law. See Ex parte Young, 209 U.S. 123, 157 (1908) ("In making an officer of the state a party defendant in a suit to enjoin the enforcement of an act alleged to be unconstitutional, it is plain that such officer must have some connection with the enforcement of the act, or else it is merely making him a party as a representative of the state, and thereby attempting to make the state a party."). "For a state officer to be a proper party, both a particular duty to enforce the statute in question and a demonstrated willingness to exercise that duty are needed." Kelly v. N.Y. State Civil Serv. Comm'n, 2015 WL 861744, at *3 (S.D.N.Y. Jan. 26, 2015).
Plaintiff alleges that Commissioner Constantino, as the state official in charge of VHA and VHC, is empowered under the ACA to engage in certain acts that may affect Plaintiff's First Amendment freedoms.
At the pleading stage, Plaintiff has adduced sufficient facts to plausibly allege that the Ex parte Young doctrine may apply to his federal constitutional claims against Commissioner Constantino and that Plaintiff may be entitled to injunctive and declaratory relief against this defendant arising out of his alleged ongoing or threatened violation of federal law. See Springfield Hosp. v. Hoffman, 2010 WL 3322716, at *6 (D. Vt. Apr. 9, 2010), aff'd, 488 F. App'x 534 (2d Cir. 2012). The State Defendants' motion to dismiss all claims against Commissioner Constantino on the basis of sovereign immunity is thus DENIED.
The court cannot, however, further find that Plaintiff has established a likelihood of success on the merits of his declaratory judgment and injunctive relief claims against Commissioner Constantino at trial. As the Supreme Court instructs, the "extraordinary and drastic remedy" of a preliminary injunction "should not be granted unless the movant, by a clear showing, carries the burden of persuasion." Mazurek v. Armstrong, 520 U.S. 968, 972 (1997). Here, Plaintiff seeks preliminary injunctive reliefwith regard to the separate payment, the segregation requirement, the tax penalty, and state and federal subsidies. Plaintiff, however, does not adequately explain how Commissioner Constantino is responsible for enforcing these components of the ACA or how an injunction directed to this state official will relieve a substantial burden on Plaintiff's religious beliefs. See Brisco v. Rice, 2012 WL 253874, at *4 (E.D.N.Y. Jan. 27, 2012) (holding that to obtain injunctive relief against a state official, "[t]he individual sued must have a direct connection to, or responsibility for, the alleged illegal action") (quotation marks omitted). Indeed, Plaintiff alleges that the Federal Defendants are responsible for enforcing these same aspects of the ACA. See Peterson, 707 F.3d at 1207 (observing that "when a state [or federal] law explicitly empowers one set of officials to enforce its terms, a plaintiff cannot sue a different official absent some evidence that the defendant is connected to the enforcement of the challenged law.").
Although Commissioner Constantino is empowered to grant exemptions from the individual mandate under the ACA, he can "provide a certificate of exemption only for the calendar year in which an applicant submitted an application for such exemption." 45 C.F.R. § 155.605(b). As Plaintiff has not applied for an exemption from the individual mandate and claims under oath that he is not entitled to one, an exemption to the individual mandate is unavailable as injunctive relief. See Annex Med., 769 F.3d at 582 (vacating preliminary injunction and remanding the case for further analysis where "it is unclear whether [plaintiff's] alleged injury is caused by the government defendants and redressable by the federal courts."). The court nonetheless proceeds to consider the merits of Plaintiff's Free Exercise and Free Speech claims against Commissioner Constantino as dismissal of those claims renders any request for injunctive relief moot. In re Methyl Tertiary Butyl Ether (MTBE) Prods. Liab. Litig., 725 F.3d 65, 105 (2d Cir. 2013) ("Standing is `the threshold question in every federal case.' Once this threshold is crossed, a plaintiff must still establish the elements of its causes of action to proceed with its case.") (citation omitted).
In Count III, Plaintiff asserts that both the Federal Defendants and Commissioner Constantino have violated his right to the free exercise of his religious beliefs under the First Amendment to the U.S. Constitution. He bases these violations on Defendants' alleged "interpret[ation] and appl[ication]" of the ACA "to require Plaintiff to pay for others' abortions in violation of his religious beliefs;" "to withhold from Plaintiff valuable government benefits to which [he is] entitled because Plaintiff refuse[s] to pay a separate fee to be used exclusively for others' abortions in violation of Plaintiff['s] religious beliefs;" and "to prevent disclosure to Plaintiff of the fact that with his insurance premium he was compelled to pay a sum to be used solely to pay for others' elective abortions in violation of his religious beliefs." (Doc. 1 at 20, ¶¶ 95-97.)
The Verified Complaint contains no specific allegations explaining how Commissioner Constantino has violated Plaintiff's Free Exercise rights. In his reply brief, Plaintiff nonetheless argues that Commissioner Constantino is a "proper party" because he approves health insurance plans for VHC and administers Vermont Premium Assistance, a state subsidy administered by VHC. The court generally does not address arguments raised for the first time in a reply brief. See Knipe v. Skinner, 999 F.2d 708, 711 (2d Cir. 1993) ("Arguments may not be made for the first time in a reply brief."). Were the court to consider this claim, it would not give rise to a Free Exercise violation because the Vermont laws with which Commissioner Constantino is connected are neutral laws of general applicability. For similar reasons, Plaintiff has failed to plausibly allege that the Federal Defendants have violated his Free Exercise rights through their enforcement of the ACA.
"The Free Exercise Clause of the First Amendment, applied against the states by incorporation into the Fourteenth Amendment provides that `Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.'" Cent. Rabbinical Cong. of U.S. & Can. v. N.Y. C. Dep't of Health & Mental Hygiene, 763 F.3d 183, 193 (2d Cir. 2014) (citation omitted) (quoting U.S. Const. amend. 1). "Thus, the First Amendment prohibits all governmental regulation of religious beliefs as such." Id. (internal quotation marks omitted). Where the government does not directly regulate religious beliefs, a plaintiff must establish a "substantial burden" on his religious beliefs which "exists where [the federal government or] the state `put[s] substantial pressure on an adherent to modify his behavior and to violate his beliefs.'" Newdow, 753 F.3d at 109 (citation omitted).
In evaluating whether a particular practice burdens a plaintiff's free exercise of his religion, the court "begins by identifying the specific conduct of which the plaintiff complains." Am. Mfrs. Mut. Ins. Co. v. Sullivan, 526 U.S. 40, 51 (1999) (internal quotation marks omitted). The conduct must be "fairly attributable" to the government because "[a]bsent government coercion or significant government encouragement of the measure under inspection[,]" "the federal government may not be held responsible for a measure taken by a private actor." Vill. of Bensenville, 457 F.3d at 64 (internal quotation marks omitted). The court has previously concluded that the majority of Plaintiff's complaints are directed at the decisions of third party health insurers who have decided to offer coverage for NFF abortion services in every health insurance plan offered in Vermont. Plaintiff has failed to make any plausible claim that the Federal Defendants are responsible for those decisions. This applies with equal force to Commissioner Constantino. See Genas v. N.Y. Dep't of Corr. Servs., 75 F.3d 825, 831 (2d Cir. 1996) ("To prevail on his Free Exercise claim, [Plaintiff] must first show that a state action sufficiently burdened his exercise of religion.").
Assuming arguendo that Plaintiff could make the requisite showing of state and federal involvement, "the right of free exercise does not relieve an individual of the obligation to comply with a valid and neutral law of general applicability on the ground that the law proscribes (or prescribes) conduct that his religion prescribes (or proscribes)." Emp't Div., Dep't of Human Res. of Or. v. Smith, 494 U.S. 872, 879 (1990) (internal quotation marks omitted). Smith thus draws a distinction between neutral, generally applicable laws, and those that "regulate religious beliefs, the communication of religious beliefs, or the raising of one's children in those beliefs." Smith, 494 U.S. at 882. "[U]nder the First Amendment, `neutral, generally applicable laws may be applied to religious practices even when not supported by a compelling governmental interest.'" Hobby Lobby Stores, Inc., 134 S. Ct. at 2761 (quoting City of Boerne, 521 U.S. at 514).
In response to a claim that the ACA's individual mandate and employer mandate violate the First Amendment, the Fourth Circuit held that:
Liberty Univ., Inc. v. Lew, 733 F.3d 72, 100 (4th Cir. 2013), cert. denied sub nom. Liberty Univ. v. Lew, 134 S.Ct. 683 (2013) (citation omitted). This conclusion is consistent with Second Circuit precedent which holds that "the critical distinction" is "between a neutral, generally applicable law that happens to bear on religiously motivated action" and a law "that restricts certain conduct because it is religiously oriented." St. Bartholomew's Church v. City of New York, 914 F.2d 348, 354 (2d Cir. 1990); see also Universal Church v. Geltzer, 463 F.3d 218, 227 (2d Cir. 2006) ("It is well established that a generally applicable law that does not target religious practices does not violate the Free Exercise clause.").
Because the ACA is a neutral and generally applicable law that does not target Plaintiff's religious beliefs, Plaintiff fails to plausibly allege that the ACA violates the Free Exercise clause of the First Amendment. For similar reasons, Vermont law implementing the ACA is also "a neutral, generally applicable law."
Because the ACA and Vermont law merely "happen[] to bear on religiously motivated action," id., pursuant to Fed. R. Civ. P. 12(b)(6), Plaintiff has failed to plausibly allege a violation of his rights under the Free Exercise clause of the First Amendment. Count III is therefore DISMISSED.
In Count IV, Plaintiff alleges Defendants violated his right to receive information under the First Amendment to the U.S. Constitution by "expressly forbid[ing] plan issuers or health insurance exchanges from advertising whether plans include abortion or informing prospective enrollees or enrollees of this important information prior to actual enrollment in the plan" and by "forbid[ding] any issuer from informing enrollees how much of their monthly payment is allocated to a separate abortion premium and used exclusively to pay for others' abortions." (Doc. 1 at 22, ¶ 108.) Plaintiff identifies a federal regulation, 45 C.F.R. § 156.280(f), as the source of his Free Speech claim. That regulation provides in relevant part that information regarding NFF abortion services shall be provided at the time of enrollment "only as part of the summary of benefits and coverage explanation" and "must provide information only with respect to the total amount of combined payments for [NFF abortion] services . . . and other services covered by the QHP." 45 C.F.R. § 156.280(f)(1), (2).
The State Defendants have proffered evidence that Plaintiff is not prohibited from seeking and obtaining additional information regarding NFF abortion services in Vermont health insurance plans. See Doc. 29 at 21-22; Doc. 29-4 at 2-3, ¶¶ 5-7; Doc. 29-7 at 1-2, ¶¶ 2-4. For purposes of analyzing the court's subject matter jurisdiction, this evidence may be considered. See Lakhani, 2013 WL 3829624, at *2 ("In reviewing subject matter jurisdiction, the Court may look to matters beyond the pleadings.").
Defendants seek dismissal of Plaintiff's Free Speech claim, noting that Plaintiff does not allege that his own speech was restricted, but rather asserts that third parties seek to engage in additional speech regarding NFF abortion services, but are precluded by federal regulation from doing so. "While it is well-established that the First Amendment protects not only the right to engage in protected speech, but also the right to receive such speech . . . it remains true that the rights of the recipients of speech . . . derive in the first instance from the primary rights of the speaker." Spargo v. N.Y. State Comm'n on Judicial Conduct, 351 F.3d 65, 83 (2d Cir. 2003). Plaintiff's Free Speech claim is therefore "entirely derivative" of third parties' freedom of expression. Id. at 83 & n.19 (observing that "there is substantial doubt as to whether plaintiffs have standing to seek equitable reliefbased on the speech of other [entities], and even if plaintiffs could demonstrate such standing, whether the controversy is sufficiently ripe for adjudication."). As a result, Plaintiff's standing to bring a Free Speech claim in this case depends on the existence of a willing speaker. See Competitive Enter. Insf. v. U.S. Dept. of Transp., 856 F.2d 1563, 1566 (D.C. Cir. 1988) (noting that "[w]hether the injury is phrased as a deprivation of information that the listener would find useful or the interference with a relationship between speaker and listener, a government regulation cannot cause that injury unless [plaintiffs] identify a willing speaker").
As Plaintiff was able to obtain the information regarding NFF abortion services coverage he needed to make a purchasing decision, he fails to plausibly allege that additional information is required by the First Amendment. Assuming arguendo that Plaintiff could overcome this obstacle, Plaintiff's Verified Complaint is silent as to the identity of any third party that seeks to communicate information regarding NFF abortion services beyond the information authorized by federal regulation. Plaintiff alleges only that "[o]n information and belief, at least some issuers and/or Vermont Health Connect employees would provide this information to enrollees . . . if they were permitted to do so." (Doc. 1 at 22, ¶ 109.) He, however, alleges no "factual information that makes the inference of [a willing speaker] plausible." Arista Records, LLC v. Doe 3, 604 FJd 110, 120 (2d Cir. 2010); see also Lakhani, 2013 WL 3829624, at *2 (observing that "because jurisdiction must be shown affirmatively, courts do not draw inferences from the pleadings in favor of the petitioner").
In the absence of a plausible allegation that there are "willing speakers" who seek to disseminate information about NFF abortion services that Plaintiff claims is necessary to fully inform himself and others, Plaintiff's Free Speech claim must be dismissed. See Bond v. Ultreras, 585 F.3d 1061, 1078 (7th Cir. 2009) ("Every circuit to have considered the question of standing in the context of a right-to-receive claim has reached the same conclusion: `in order to maintain a `right to listen' claim, a plaintiff must clearly establish the existence of a `willing speaker.' In the absence of a willing speaker, an Article III court must dismiss the action for lack of standing.'") (citation omitted). Count IV is therefore DISMISSED pursuant to Fed. R. Civ. 12(b)(1) and 12(b)(6).
For the reasons stated above, the court GRANTS IN PART and DENIES IN PART the Federal Defendants' motion to dismiss (Doc. 40); GRANTS the State Defendants' motion to dismiss (Doc. 39); and DENIES Plaintiff's motion for a preliminary injunction (Doc. 2). Plaintiff's claims against all Defendants are hereby DISMISSED with the exception of Plaintiff's RFRA claim against the Federal Defendants seeking declaratory relief regarding the Federal Defendants' enforcement of the separate payment and segregation requirement under the ACA.
SO ORDERED.
Exec. Order No. 1353575, 75 Fed. Reg. 15,599 (Mar. 24, 2010).