Lead Opinion
Affirmed by published opinion. Judge DUNCAN wrote the opinion, in which Judge JACKSON joined. Chief Judge WILLIAMS wrote a separate opinion concurring in part and dissenting in part and concurring in the judgment.
OPINION
Long Term Care Partners, LLC (“LTC Partners”) challenges the assumption of jurisdiction by the Equal Employment Opportunity Commission (“EEOC” or “Commission”) over actions brought by federal employees against the Office of Personnel Management (“OPM”) arising from OPM’s participation in an allegedly discriminatory contract with LTC Partners. The district court dismissed LTC Partners’ claim, holding that the limited exception to the finality requirement for review of administrative agency action outlined in Leedom v. Kyne,
I.
Congress enacted the Long-Term Care Security Act (“LTCSA”), 5 U.S.C.
The Program does not provide universal coverage. § 9002(e)(3). Instead, each individual must apply for coverage using a form prescribed by the carrier and approved by OPM. 5 C.F.R. § 875.401(a). The carrier has discretion, within the limits set forth in the master contract, to accept or reject applications. 5 U.S.C. § 9003(c); 5 C.F.R. § 875.407.
Pursuant to its authority under the LTCSA, OPM entered into a master contract with LTC Partners, a consortium created by John Hancock Life Insurance Company and Metropolitan Life Insurance Company.
In July 2002, Ralph D. Rouse, Jr., a federal employee, submitted an application for insurance to LTC Partners. The application form, designed by LTC Partners and approved by OPM, required applicants to indicate whether they used “medical devices, aids, or treatments,” and listed wheelchairs as a specific example. J.A. 256. The form stated that an affirmative response to the “medical devices, aids, or
In proceedings before an EEOC Administrative Law Judge (“ALJ”), OPM argued that Rouse’s complaint should be dismissed because the EEOC did not have jurisdiction to review LTC Partners’ insur-ability decision. The ALJ rejected this argument, finding that it “confuse[d] jurisdiction under the Americans with Disabilities Act (ADA) with eligibility determinations under the LTCSA” and holding that “the Commission has jurisdiction under the ADA to determine whether OPM has participated in a contract which makes disability-based distinctions in the eligibility requirements of its insurance plan.” Rouse v. Director, Office of Personnel Management, Case No. 100-2005-00025X (E.E.O.C. October 27, 2005) (order denying OPM’s motion to dismiss); J.A. 106-07. Under relevant sections of the ADA, OPM is prohibited from
participating in a contractual or other arrangement or relationship that has the effect of subjecting a covered entity’s qualified applicant or employee with a disability to the discrimination prohibited by this subchapter (such relationship includes a relationship with an employment or referral agency, labor union, an organization providing fringe benefits to an employee of the covered entity, or an organization providing training and apprenticeship programs)!.]
42 U.S.C. § 12112(b)(2). The EEOC had jurisdiction to determine whether OPM discriminated against Rouse under this section of the ADA, the ALJ determined, despite the limitations on review of LTC Partners’ insurability decisions set forth in the LTCSA and the master contract.
In two subsequent appeals, the EEOC has reinforced its view of the limited extent to which it may exercise jurisdiction in cases like Rouse. See Fornaro v. Blair, E.E.O.C. Doc. 01A53949,
On February 23, 2006, LTC Partners filed suit against the United States in federal district court. The complaint, as later amended, alleged that the EEOC had asserted jurisdiction over LTC Partners’ in-surability decisions in contravention of the LTCSA and its implementing regulations. LTC Partners sought (1) a declaration that the EEOC was without jurisdiction to review insurability decisions made under the Program, and (2) a permanent injunction preventing the EEOC from asserting such jurisdiction.
II.
On appeal, the government first contends that LTC Partners lacks standing to challenge the EEOC’s exercise of jurisdiction over its contractual partner, OPM. The district court did not reach this issue. However, standing implicates this court’s subject matter jurisdiction, and it may therefore be appropriately considered on appeal. Fed.R.Civ.P. 12(h)(3); see Sucampo Pharm., Inc. v. Astellas Pharma, Inc.,
LTC Partners claims injury based on the EEOC’s exercise of jurisdiction over its contractual partner, OPM. LTC Partners argues that this exercise of jurisdiction guts its right to enjoy the limitations on review imposed by the LTCSA; forces it to expend resources on administrative litigation whether or not it is a party to the proceedings; and imperils the contract through the threat of an adverse ruling on the merits against OPM in the pending EEOC actions. The government responds by noting that EEOC decisions on the merits in Fornaro and James would operate only against OPM, arguing that any projected downstream effects of such rulings on LTC Partners are too conjectural or hypothetical to confer Article III standing.
Notwithstanding the government’s invocation of standing concerns, we decline, as did the district court, to decide this case on standing grounds. This court previously determined that analysis of whether a case presents “final agency action” should precede a standing inquiry. Flue-Cured Tobacco Coop. Stabilization Corp. v. EPA
The continued validity of this portion of the decision in Flue-Cured Tobacco has
Relying on Arbaugh, the Court of Appeals for the District of Columbia has held that the requirement of final agency action under section 10(c) of the APA, 5 U.S.C. § 704, is not jurisdictional. Trudeau v. FTC,
Nevertheless, the Supreme Court recently clarified, relying on Steel Co. v. Citizens for a Better Environment,
Thus, under Sinochem, it is of no moment whether Arbaugh renders our Lee
III.
Judicial review under the APA is limited to “final agency action for which there is no other adequate remedy in a court.” 5 U.S.C. § 704.
LTC Partners claims that this case fits both criteria for exercise of Leedom jurisdiction and that the district court erred by holding otherwise. First, LTC Partners argues that the EEOC, in exercising jurisdiction in Rouse, Fornaro, and James, acted contrary to the LTCSA’s clear and mandatory prohibition of review of carriers’ eligibility determinations except “to the extent and in the manner provided in the applicable master contract.” 5 U.S.C. § 9003(c)(2). LTC Partners asserts that the second Leedom requirement is also met in this case because it has no meaningful and adequate means, apart from this litigation, of vindicating its perceived right under § 9003 and the master contract not to be forced to defend its insurability decisions before the EEOC. See MCorp,
A.
We begin by examining LTC Partners’ argument that the EEOC acted contrary to a clear and mandatory requirement in the LTCSA. In Leedom, the Supreme Court construed a statute dealing with the certification of collective bargaining units by the National Labor Relations Board (“NLRB”). The statute provided that the NLRB “shall not ... decide that any unit is appropriate for [collective bargaining] purposes if such unit includes both professional employees and employees who are not professional
The Supreme Court has since reinforced the “narrow limits” of Leedom. See Boire v. Greyhound Corp.,
In this case, the statute provides, “A carrier’s determination as to whether or not a particular individual is eligible to obtain long-term care insurance coverage under this chapter shall be subject to review only to the extent and in the manner provided in the applicable master contract.” 5 U.S.C. § 9003(c)(2). LTC Partners argues that in exercising jurisdiction over cases brought by federal employees aggrieved by LTC Partners’ eligibility determinations, the EEOC violated the clear, specific, and mandatory prohibition of 5 U.S.C. § 9003. See id. (“A carrier’s [eligibility] determination[s] ... shall be subject to review only [as] provided in the applicable master contract.”) (emphasis added). There is no serious dispute about the mandatory nature of this provision or that it is specific and clear as it pertains to carriers’ eligibility determinations. The EEOC has repeatedly drawn a line, however, between review of carriers’ eligibility determinations and scrutiny of OPM’s participation in a contractual relationship that has the alleged effect of discriminating against federal employees. The question before us is whether the distinction drawn by the agency is a reasonable one. In deciding it, we need not reach the ultimate
Rouse, Fomaro, and James reflect the EEOC’s determination that although § 9003 clearly and specifically prohibits review of LTC Partners’ eligibility determinations, it does nothing to inhibit EEOC review of OPM’s participation in allegedly discriminatory contractual relationships. The EEOC OFO has espoused the view that the latter inquiry is governed by the ADA, 42 U.S.C. § 12112(b)(2), and is unaffected by the specific prohibition in the LTCSA, 5 U.S.C. § 9003(c)(2). To hold otherwise, the OFO found, “would be to allow [OPM] to potentially enter into any contract term which violates federal law or discriminates against whole groups of individuals on the basis of their protected class.” Fornaro,
LTC Partners argues in response that review of its eligibility decisions and scrutiny of the master-contract terms require the same ultimate inquiry: whether a claimant was subjected to discrimination based on disability when he was denied coverage under the Program. According to LTC Partners, this broad inquiry and all of its component parts are foreclosed to anyone but LTC Partners under the LTCSA, 5 U.S.C. § 9003(c)(2). By asserting jurisdiction to review OPM’s participation in the master contract, LTC Partners concludes, the EEOC is engaging in the prohibited act of reviewing its insura-bility determinations.
This argument is severely undercut by provisions of the ADA protecting insurers’ risk-based eligibility judgments. Such judgments are insulated from scrutiny so long as they are not “used as a subterfuge to evade the purposes of [the ADA].” 42 U.S.C. § 12201(c). The OFO has recognized that these statutory provisions render the EEOC powerless to overturn insurers’ decisions “strictly concerning an individual’s ‘insurability.’ ” Fornaro,
The court below found merit in the EEOC’s distinction between review of an individual eligibility determination and what the court characterized as the “macro issue” in the case — review of OPM’s participation in an allegedly discriminatory contractual relationship. As a result, the court concluded that the record before it contained no clear indication that the EEOC had acted beyond its jurisdiction.
We agree with the conclusion urged by the government and reached by the district court. The distinction drawn in the EEOC cases may not be compelled, but it is certainly a “plausible” one, reached upon sound analysis after thorough inquiry, and grounded in the language of the ADA. See Hanauer,
B.
Even if we were to reach a contrary conclusion, LTC Partners could not show that the EEOC’s exercise of jurisdiction in Rouse, Fomaro, and James “wholly deprive [d] [LTC Partners] of a meaningful and adequate means of vindicating its statutory rights,” MCorp,
LTC Partners claims the EEOC’s assertion of jurisdiction in proceedings like Fornaro and James threatens to sacrifice or obliterate its statutory right to enjoy limitations on review of its insurability determinations under the LTCSA. See Leedom,
LTC Partners’ argument is both over-broad and fraught with complications. First, as discussed at length supra, the so-called “immunity” granted to “[a] carrier’s determination as to whether or not a particular individual is eligible to obtain long-term care insurance coverage,” § 9003(c)(2), may or may not also attach to the EEOC’s review of OPM’s participation in a contractual arrangement that has the alleged effect of subjecting federal employees to discrimination. Moreover, LTC Partners’ “immunity” argument suffers from the obvious deficiency that LTC Partners is a private party and not a sovereign entity. This case presents neither the constitutional scope inherent in the sovereign immunity doctrine nor its rationale of shielding the sovereign from “the indignity of [being] subjected] ... to the coercive process of judicial tribunals at the instance of private parties,” In re Ayers,
IV.
LTC Partners argues, in the alternative, that the EEOC’s exercise of jurisdiction in Rouse, Fomaro, and James is final agency action under the APA. However, “[q]uestions not raised and properly preserved in the trial forum will not be noticed on appeal, in the absence of exceptional circumstances.” United States v. One 1971 Mercedes Benz,
All of the ingredients for LTC Partners’ generalized claim — that the EEOC acted outside its jurisdiction in hearing Rouse, Fomaro, and James — were presented in LTC Partners’ first amended complaint. J.A. 91 (“EEOC’s action in asserting jurisdiction to review LTC Partners’ insurability decisions and the related proceedings are outside its authority, arbitrary, capricious, an abuse of discretion, and otherwise ... in violation of the [APA][.]”). However, LTC Partners disavowed this claim in the proceedings below, labeling it a “straw-man argument” offered by the government, Pl.’s Opp. Mot. Dismiss at 9, calling discussion of it “beside the point,” id., and acquiescing in the court’s suggestion at the hearing that both parties agreed they were not dealing with a final agency decision, J.A. 182. That LTC Partners chose not to present the APA argument to the district court, instead disclaiming the argument and train-litigation change in strategy cannot alone amount to an exceptional or extraordinary circumstance that might nullify waiver and justify review.
For the foregoing reasons, we affirm the district court’s holding that the Leedom exception to the finality requirement for review of agency action did not apply in this case. The district court’s grant of the government’s motion to dismiss is therefore
AFFIRMED.
Notes
. Covered employees are responsible for the entire cost of insurance, unsubsidized by the government. § 9004(a).
. LTC Partners is the only qualified carrier under the LTCSA.
. The Director of Underwriting for LTC Partners described this review as follows: "Should the original underwriting decision be upheld, the applicant may request a second, and final reconsideration review. A senior level/supervisory underwriter or a Medical Director at John Hancock or MetLife reviews that decision. The individuals reviewing the second level reconsideration, while knowledgeable of the underwriting protocols for the [Program], have no involvement with the initial or subsequent denial and act as independent reviewers." J.A. 24-25.
. Rouse's claim did not involve a dispute over medical judgments. Therefore, the second-level review, including review of records by Rouse’s physician and subsequent reconsideration by LTC Partners' underwriting staff, was unavailable in Rouse’s case.
. The underlying substantive questions— whether long-term care insurance is a fringe benefit; whether denial of insurance coverage concerns a term, condition, or privilege of employment; and whether the master contract subjects federal employees to the discrimination prohibited by the ADA — are not before us.
. At the time of oral argument in this case, both Fomaro and James remained pending before OPM.
. LTC Partners also moved to enjoin proceedings in Rouse and sought an order compelling the EEOC to permit LTC Partners to intervene in those proceedings. The district court ultimately granted LTC Partners’ requested permission to intervene. Rouse subsequently abandoned his EEOC claim and sought relief against OPM in federal district court, later adding LTC Partners as a party to that action. Rouse v. Springer, No. 06-2088 (D.D.C. filed Dec. 8, 2006). LTC Partners has not sought to intervene in the ongoing proceedings in Fornaro or James.
. At the district court's behest, LTC Partners then filed a second amended complaint, reasserting its original challenge to EEOC jurisdiction and adding a new claim seeking declaratory judgments (1) that denials of coverage to wheelchair users under the Program did not violate the ADA or any other provision of law, and (2) that LTC Partners’ rejection of Rouse's application was valid and lawful. The court dismissed the new claim as it pertained to the United States for lack of subject matter jurisdiction, concluding there was no indication that LTC Partners and the United States, as contractual partners, maintained adverse interests as to the claim. The dismissal of the new claim in the second amended complaint has not been appealed.
. It is also open to question whether LTC Partners could satisfy the redressibility requirement of Article III standing. Here, LTC Partners sought a declaration from the district court that "the EEOC’fs] assertion of jurisdiction to review insurability decisions made by LTC Partners is void as in excess of EEOC’s statutory jurisdiction and authority,” and a related injunction on the exercise of such jurisdiction. J.A. 94. But the EEOC explicitly acknowledged in Fomaro and James its lack of authority to review insurability decisions. See Fornaro,
. Though not relevant here, the APA also provides that a court may review agency action made reviewable by statute. § 704.
.LTC Partners also analogizes to the qualified immunity doctrine. This analogy fails for similar reasons. See Mitchell v. Forsyth,
. This question is kept alive through the ongoing proceedings in Fornaro and James.
. In any event, "final agency action” here would necessarily entail the agency's issuance of a definitive ruling that had some immediate "legal force or practical effect” on LTC Partners other than “the disruptions that accompany any major litigation.” FTC v. Standard Oil Co.,
Concurrence Opinion
concurring in part and dissenting in part and concurring in the judgment:
I join in full in Parts I, III.B, and IV of the majority opinion and, accordingly, I concur in the result reached in Part V, affirming the dismissal of the complaint by Long Term Care Partners, LLC (“LTC Partners”). I write separately, however, because I believe that, in light of Arbaugh v. Y&H Corp.,
Instead, I would first consider that question and answer it in the affirmative. Furthermore, I believe that LTC Partners has met its burden of proving that the Equal Employment Opportunity Commission (“EEOC”) is violating a clear statutory mandate, in satisfaction of Leedom’s first prong. I concur in the judgment of the court, however, because I agree with the conclusion, reached in Part III.B, that LTC Partners cannot show our failure to act in this case “would wholly deprive” it “of a meaningful and adequate means of vindicating its statutory rights.” Bd. of Governors, Fed. Reserve Sys. v. MCorp. Fin., Inc.,
I.
A.
In Flue-Cured Tobacco Coop. Stabilization Corp. v. E.P.A.,
Flue-Cured Tobacco entered us into a circuit-split at the time it was decided, see Reliable Automatic Sprinkler Co. v. Consumer Prod. Safety Comm’n,
If the Legislature clearly states that a threshold limitation on a statute’s scope shall count as jurisdictional, then courts and litigants will be duly instructed and will not be left to wrestle with the issue .... But when Congress does not rank a statutory limitation on coverage as jurisdictional, courts should treat the restriction as nonjurisdictional in character.
Arbaugh,
The Court then applied its “readily ad-ministrable bright line” to find that the numerosity requirements in Title VII were not jurisdictional but “an element of a plaintiffs claim for relief.” Id. at 516,
In the wake of Arbaugh, at least two circuits have considered whether § 704 of the APA implicates the subject matter jurisdiction of the federal courts and both concluded, with little hesitation, that § 704 falls on the non-jurisdictional side of Arbaugh’s bright-line rule. See Trudeau v. Fed. Trade Comm’n,
Accordingly, because § 704 of the APA does not contain a clear statement implicating our subject matter jurisdiction, the “final agency action” requirement contained therein, like the numerosity requirement in Title VII, is “nonjurisdictional in character.” Arbaugh,
B.
Having concluded that § 704’s “final agency action” requirement does not impact our subject matter jurisdiction, we must next decide whether this conclusion nonetheless permits us to consider the presence of final agency action before considering LTC Partners’ standing. The question of LTC Partners’ standing does impact our subject matter jurisdiction, for standing is “an integral component of the case or controversy requirement.” Miller v. Brown,
The majority, relying on the Supreme Court’s even more recent decision in Sinochem Int’l Co. v. Malaysia Int’l Shipping Corp., — U.S. -,
By advancing to the inquiry into final agency action under the APA in this ease without first addressing LTC Partners’ standing, the majority violates the principle announced in Steel Co. v. Citizens for a Better Environment,
II.
A.
Although the district court declined to address LTC Partners’ standing below, the United States renews this argument on appeal and, because “[i]t is well settled that under Article III of the United States Constitution, a plaintiff must establish that a ‘case or controversy’ exists,” Smith v. Frye,
Standing has three components:
First, the plaintiff must have suffered an “injury in fact” — an invasion of a legally protected interest which is (a) concrete and particularized, and (b) “actual or imminent, not ‘conjectural’ or ‘hypothetical.’ ” Second, there must be a causal connection between the injury and the conduct complained of — the injury has to be “fairly ... trace[able] to the challenged action of the defendant, and not ... th[e] result [of] the independent action of some third party not before the court.” Third, it must be “likely,” as opposed to merely “speculative,” that the injury will be “redressed by a favorable decision.”
LTC Partners, as the party asserting federal jurisdiction, has the burden of establishing these requirements. Id. at 561,
Some cases, such as this one, illustrate that the distinction between the inquiry into a litigant’s Article III standing to bring a claim and the inquiry into the ultimate merits of the plaintiffs claim is often a fine one. See, e.g., Town of Norwood v. F.E.R.C.,
Moreover, the Court has cautioned that inquiry into the merits cannot precede inquiry into the Article III standing question without running the risk of rendering the merits inquiry nothing more than an advisory opinion; this illustrates the chronological differences between the two inquiries. Steel Co.,
B.
The current case remains at the pleading stage, with the district court having granted the United States’ motion to dismiss. The stage of litigation is significant because, given that the elements of standing “are not mere pleading requirements but rather an indispensable part of the plaintiffs case, each element must be supported in the same way as any other matter on which the plaintiff bears the burden of proof, i.e., with the manner and degree of evidence required at the successive stages of the litigation.” Lujan,
Pursuant to this framework, I would conclude that LTC Partners possesses standing to pursue this action. In its original complaint, LTC Partners alleged that it is being injured by the EEOC’s exercise of jurisdiction over its “insurability decisions” and that this exercise is “outside [the EEOC’s] authority, arbitrary, capricious, ... and otherwise not in accordance with law.” (J.A. at 91.) Such an allegation, at this stage of the litigation, is sufficient to show injury in fact. The Court has found that, “[w]hen the suit is one challenging the legality of government action or inaction, the nature and extent of facts that must be [alleged] ... in order to establish standing depends considerably upon whether the plaintiff is himself an object of the action (or forgone action) at issue.” Lujan,
Moreover, under Warth, an injury in fact can “exist solely by virtue of statutes creating legal rights, the invasion of which creates standing.”
The causation and redressability requirements for standing are also met here. Neither party disputes that the EEOC is causing this alleged injury. And LTC Partners’ requested relief is likely to redress the alleged injury; LTC Partners requested a declaration that the EEOC’s “assertion of jurisdiction to review insura-bility decisions ... is void” and a declaration that “the EEOC is without jurisdiction to review insurability decisions made pursuant to the [Federal Long Term Care Insurance Program].” (J.A. at 94.) The majority suggests that this requested relief may not redress LTC Partners’ injury because the EEOC claims (and the majority agrees) that the EEOC is actually not reviewing individual insurability determinations, but only the Master Contract entered by the Office of Personal Management (“OPM”). This suggestion, however, overlooks the fact that LTC Partners’ standing “in no way depends on the merits of the plaintiffs contention that particular conduct is illegal.” Warth,
In sum, given that this case remains at the pleading stage, I would find that LTC Partners has met its burden of providing that it has standing to pursue its claim that the EEOC is exercising jurisdiction over its insurability decisions in a manner contrary to law.
III.
Having concluded that LTC Partners has standing to maintain this action, I next turn to the question of final agency action and the Leedom exception. On this issue, I disagree with the majority that LTC Partners has failed in its burden to prove it can satisfy Leedom's first prong. Instead, because the plain language of the Long Term Care Security Act, (“LTCSA”), 5 U.S.C.A. §§ 9001-9009 (West 2007), provides that a “carrier’s determination as to whether or not a particular individual is eligible to obtain long-term care insurance coverage under this chapter shall be subject to review only to the extent and in the manner provided in the applicable master contract,” 5 U.S.C.A. § 9003(c)(2), and the master contract between LTC Partners and OPM does not provide for review by the EEOC, I would find that the EEOC is violating a clear statutory mandate. I agree in full, however, with the majority’s conclusion, in Part III.B, that LTC Partners cannot satisfy Leedom’s second prong, because LTC Partners cannot show our failure to act “would wholly deprive” it “of a meaningful and adequate means of vindicating its statutory rights.” MCorp. Fin.,
And, as part of the claim for relief, failure to prove or plead final agency action would result in failure to file a claim upon which relief may be granted. See Federal Rule of Civil Procedure 12(b)(6). Dismissal based upon that ground must be considered dismissal on the merits for purposes of res judicata. See Federal Rule of Civil Procedure 41(b).
