Ass'n of American Physicians & Surgeons v. Sebelius
746 F.3d 468
D.C. Cir.2014Background
- AAPS and Alliance for Natural Health USA sue the Secretary of Health and Human Services and SSA Commissioner in district court over ACA and Medicare-related actions.
- Plaintiffs challenge 26 U.S.C. § 5000A as unconstitutional under takings and origination clauses.
- Plaintiffs raise APA and statutory challenges to SSA POMS and Medicare rules as improperly adopted or applied.
- IFR and 2009–2010 Medicare changes are challenged on procedural and substantive grounds; mootness is argued for the interim rule.
- Plaintiffs seek an accounting of Medicare/Social Security finances as a fiduciary injury; district court dismissed for lack of standing or merit.
- Court affirms dismissal of all claims on jurisdictional and merits grounds, none of the plaintiffs' claims survive review.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Constitutional challenge to § 5000A takings | AAPS argues the tax is an unlawful taking without just compensation | Defendants defend the tax as a valid exercise of the taxing power | Claims rejected; affirm district court. |
| Origination clause challenge to ACA | Bill originated in House; Senate amendments made it revenue-raising | NFIB decision governs; bills can originate in House and be amended | Challenge conceded/unsupported; upheld dismissal. |
| APA/notice-and-comment for POMS provisions | POMS exceed statutory authority and require notice-and-comment | POMS interpretation precluded by Medicare Part A text; no redress via APA | Dismissed; Hall controls; no APA redress. |
| Mootness of IFR and Change Requests | IFR and 2009 changes injure stakeholders and require review | 2012 rule superseded; mootness defeats claims; substantive changes noted | Moot; claims dismissed. |
| Accounting claim standing | SSA/Secretary fiduciary duties injure physicians’ interests in solvency | No cognizable standing or jurisdiction for accounting claim | No standing; jurisdiction lacking; claim dismissed. |
Key Cases Cited
- National Federation of Independent Business v. Sebelius, 132 S. Ct. 2566 (U.S. 2012) (upheld individual mandate as a tax power)
- Brushaber v. Union Pacific Railroad Co., 240 U.S. 1 (U.S. 1916) (takings analysis for valid taxes; not a confiscation)
- Hall v. Sebelius, 667 F.3d 1293 (D.C. Cir. 2012) (Medicare Part A entitlements are statutory; cannot opt out)
- Sissel v. U.S. Dept. of Health & Human Servs., 951 F. Supp. 2d 159 (D.D.C. 2013) (related origination/APA considerations in district court)
- Lujan v. Defenders of Wildlife, 504 U.S. 555 (U.S. 1992) (standing requirements; concrete injury)
- Steel Co. v. Citizens for a Better Environment, 523 U.S. 83 (U.S. 1998) (jurisdictional questions; merits proceedings)