Missouri Insurance Coalition v. Huff
947 F. Supp. 2d 1014
E.D. Mo.2013Background
- Missouri Senate Bill 749 added Mo.Rev.Stat. § 376.1199, requiring some contraceptive coverage provisions and a broad opt-out mechanism for moral, ethical, or religious objections.
- Plaintiffs MIC, Health Alliance, and HMO Missouri sue to declare § 376.1199 void under the Supremacy Clause as conflicting with the ACA contraceptive mandate and its regulations.
- Defendant Huff, as Missouri DOI Director, administered the challenged state-law provisions and threatened penalties for noncompliance.
- The ACA requires contraceptive coverage without cost-sharing in group plans and issuers, supported by HRSA guidelines, with penalties for noncompliance; some exemptions exist (religious employers, grandfathered plans, etc.).
- Missouri’s § 376.1199 includes an opt-out for employers and enrollees and requires insurers to inform enrollees of their right to exclude contraceptives, creating potential conflict with the federal mandate.
- There were interim procedural steps: a TRO was issued; subsequent briefing included amicus briefs; the case proceeded to declaratory judgment and injunctive relief.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Is § 376.1199 preempted by the ACA and implementing regulations? | Direct conflict; compliance with both is impossible. | Missouri law is protective and may co-exist or be severable. | Subsections 1(4), 4, 5, and 6(1)-(3) are preempted. |
| Are the remaining subsections of § 376.1199 valid and non-preempted? | Non-preempted portions should be invalidated to avoid conflict. | Other subsections can operate where federal exemptions exist; severability possible. | Subsections 1(2), 1(3), 2, 3, 6(4), and 6(5) are not preempted. |
| Should the court invalidate the entire statute or sever invalid portions? | Invalidating only the conflicting parts suffices; otherwise the whole statute fails. | Only the conflicting portions need be addressed; severability is appropriate. | Invalidate subsections 1(4), 4, 5, 6(1)-(3); subsection 1(4) also invalidates to preserve consistency with federal law. |
| Should the court delay resolution pending RFRA cases or federal rulemaking on exemptions? | Abeyance would avoid inconsistent results; federal developments may resolve conflicts. | Proceed now; RFRA challenges differ and do not resolve state-federal conflict here. | Declined to abate; proceed with declaratory judgment; delays not warranted. |
Key Cases Cited
- Qwest Corp. v. Minn. Pub. Utils. Comm’n, 684 F.3d 721 (8th Cir. 2012) (Supremacy Clause applies where state and federal law conflict or obstruct federal objectives)
- Fid. Fed. Sav. & Loan Ass’n v. de la Cuesta, 458 U.S. 141 (1982) (federal preemption has force equal to federal law; preemption principles apply to regulations)
- O’Brien v. HHS, 894 F. Supp. 2d 1149 (E.D. Mo. 2012) (RFRA injunctions; likelihood of success on merits matters for stay/enforcement decisions)