Nebraska ex rel. Bruning v. United States Department of Health & Human Services
2012 U.S. Dist. LEXIS 104419
D. Neb.2012Background
- Seven State plaintiffs (Nebraska, South Carolina, Michigan, Texas, Florida, Ohio, Oklahoma) sue; organizational and individual Catholic plaintiffs join in asserting ACA contraceptive coverage Rule violates First Amendment and RFRA.
- Rule governs coverage for contraceptive services in non-grandfathered plans; religious-employer exemption exists; temporary enforcement safe harbor provides delay until Aug. 1, 2013.
- Rule was finalized Feb. 15, 2012; HRSA guidelines and amendments define religious employer and exemptions; several lawsuits challenge the Rule’s religious accommodations.
- Organizational plaintiffs allege their health plans (non-grandfathered) would be compelled to subsidize contraception contrary to beliefs; some plans are grandfathered but may change, risking coverage under the Rule.
- Individual plaintiffs allege their plans (some non-grandfathered) would subject them to contraception coverage contrary to beliefs; they claim potentially imminent injury.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Do organizational plaintiffs have standing to sue? | Plaintiffs allege injury from Rule forcing coverage and coercion of beliefs. | No injury-in-fact; plans may be grandfathered; injury uncertain and contingent on third-party actions. | Lacks standing; failure to plead non-grandfathered status plausibly; claims dismissed. |
| Do individual plaintiffs have standing to sue? | Sister Mary Catherine and Molai face coerced coverage contrary to beliefs; injury imminent if plan not grandfathered. | Plan status not plausibly non-grandfathered; no imminent injury. | Lacks standing; failed to plead non-grandfathered status; claims dismissed. |
| Do State plaintiffs have standing to sue in their own right? | State budgets would strain if religious employers drop coverage or shift costs to Medicaid. | Injury speculative; causation depends on third-party actions by employers and enrollees. | Lacks Article III standing; injuries too conjectural; prudential standing also lacking. |
| Are the State claims ripe for judicial review? | Rule is final and definitively defined; harm imminent. | Rule is being amended; temporary safe harbor delays enforcement; ongoing rulemaking. | Not ripe; contingent future events; deferral appropriate; dismissible on ripeness grounds. |
| Should the complaint be dismissed under Rule 12(b)(1)/(b)(6) for lack of standing/ripe claims? | Standing and ripeness exist; claims challenging constitutional rights and RFRA. | Lack of standing and ripe; no plausible injury; statutory/Constitutional zone of interests not met. | Granted; complaint dismissed without prejudice. |
Key Cases Cited
- Lujan v. Defenders of Wildlife, 504 U.S. 555 (1992) (establishes standing elements and injury in fact)
- Abbott Laboratories v. Gardner, 387 U.S. 136 (1967) (pre-enforcement review; finality and readiness for review)
- Bell Atl. Corp. v. Twombly, 550 U.S. 544 (2007) (pleading must show plausible entitlement to relief)
- Ashcroft v. Iqbal, 556 U.S. 662 (2009) (limits on conclusory legal allegations in complaints)
- Missouri Roundtable for Life v. Carnahan, 676 F.3d 665 (8th Cir. 2012) (ripeness and contingency of future events in standing)
- Block Iowa ex rel. Miller v. Block, 771 F.2d 347 (8th Cir. 1985) (standing proximity; defendant actions must directly connect to state injury)