NATIONAL COAL ASSOCIATION, Alаbama Land and Mineral Corporation, Allied Signal, Inc., Berwind Corporation, Bethlehem Steel Corporation, Costain Coal, Inc., LTV Steel Company, Mountain Laurel Resources Company, The Pittston Company, Plaintiffs-Appellees, v. Shirley S. CHATER, Commissioner of Social Security, Defendant-Appellant.
No. 95-6781.
United States Court of Appeals, Eleventh Circuit.
April 26, 1996.
1077
Because the district court errеd in denying BP‘s motion for judgment as a matter of law on all of the dealers’ claims,9 we reverse the district court‘s judgment.
REVERSED AND RENDERED.
Alan Frank, U.S. Dept. Health and Human Services, Jeffrey Clair, U.S. Dept. of Justice, Civ.Div., Washington, DC, for appellant.
Willis J. Goldsmith, Jones Day Reavis & Poge, Washington, DC, John R. Woodrum, Ronald E. Meisburg, Jennifer L. Kim, Smith Heenan & Althen, Washington, DC, for appellees.
Before TJOFLAT, Chief Judge, COX, Circuit Judge, and CLARK, Senior Circuit Judge.
PER CURIAM:
The Commissioner of Social Security appeals from a grant of summary judgment for the plaintiffs, requiring her to recompute premiums paid by coal operators under a federal statute that creates a benefits plan for mine workers. The sole issue in this appeal is the meaning of the word “reimbursements” as used in the statutory formula for calculating health benefit premiums. We affirm the district court.
The financial instability of health and retirement benefit plans for mine workers and retirees historically has been a significant factor precipitating disputes between mine workers and coal operators. From 1946 to 1992, health benefits for miners were provided through a series of multiemployer plans creаted under agreements between the United Mineworkers of America (UMWA) and the National Bituminous Coal Operators’ Association. By 1989, the two multiemployer plans that provided health benefits to retirees, the 1950 UMWA Benefit Plan and Trust, and the 1974 UMWA Benefit Plan and Trust, were operating at a deficit. The financial instability of the plans led to a breаkdown in labor relations: the Pittston Company ceased making contributions to the plans in 1990, and an eleven-month strike ensued. In re Chateaugay Corp., 53 F.3d 478, 484 (2d Cir.), cert. denied, U.S., 116 S.Ct. 298, 133 L.Ed.2d 204 (1995).
Congress recognized the potential for continued disruption in the coal industry without an adequately funded source for the continued provision of benefits. With the aid of a study on the issue by a Department of Labor commission,1 Congress passed the Coal Industry Retiree Health Benefit Act (“the Act“),
The Commissioner ... shall calculate a per beneficiary premium for each plan year beginning on or after February 1, 1993, which is equal to the sum of—
(A) the amount determined by dividing—
(i) the aggregate amount of payments from the 1950 UMWA Benefit Plan and the 1974 UMWA Benеfit Plan for health benefits (less reimbursements but including administrative costs) for the plan year beginning July 1, 1991, for all individuals covered under such plans for such plan year, by
(ii) the number of such individuals ...2
In order to understand the controversy in this case, it is important to understаnd how the 1950 and 1974 UMWA Benefit Plans acted in combination with government benefits programs, like Medicare, to provide health care services for beneficiaries. Health care coverage under the former UMWA plans was limited to services that were not covered by Medicare or other government benefit progrаms. But to promote efficiency for the payors and convenience for the beneficiaries, the UMWA plans entered into a series of agreements with the Health Care Financing Administration (“HCFA“), the governmental agency that administers Medicare, under which the UMWA plans would pay providers all the covered costs of the bеneficiaries’ health care. Medicare would then reimburse the UMWA plans for services covered by Medicare Part B3 and related administrative costs.
Prior to June of 1990, the payments made by HCFA pursuant to its agreement with the
In 1990, the UMWA plans and HCFA signed a new contract that employed a risk-capitation method for calculating the payments from HCFA to the benefit plans. (R. 2-28 Defs.’ Ex. 5.) Under the new method, HCFA paid a predetermined amount per plan member per month, without regard to the amount of money that the UMWA plans actually spent on Medicare-covered services. The risk-capitation method was considered desirable by both parties. The UMWA plans hoped that using this method would prevent the protracted disputes that had occurred over the amount of the HCFA payments. HCFA favored the risk-capitation method because it gave the UMWA plans thе incentive to provide Medicare-covered services more efficiently, and because the amount of its payment to the plans would be more certain.
The contract between HCFA and the UMWA plans using the risk-capitation method has been renewed every year since its inception; the Combined Fund has been substituted for the UMWA plans. The 1990 contract, as well as each of the renewal contracts in the record, characterize the payment made by HCFA to the UMWA plans under the contract alternatively as a “payment” or “capitation payment“, and as “reimbursement.” (R. 2-28 Defs.’ Exs. 5, 6, 7.)4
The Act requires the trustees of the Combined Fund to submit to the Cоmmissioner “information as to the benefits and covered beneficiaries under the fund, and such other information as the [Commissioner] may require to compute any premium under this section.”
Under the formula in
II. Proceedings Below
In April of 1994, the National Coal Association (“NCA“) and eight companies who are assigned premium payment obligations under the Act filed suit in federal district court,5
III. Issue on Appeal and Standard of Review
The parties to this appeal do not disagree on any issue of fact. The sole issue in this appeal is the meaning of the word “reimbursement” in
IV. Discussion
The Commissioner contends that her reading of
NCA argues that the district court did not err in holding that the plain meaning of “reimbursement” refers to thе entire amount of the capitation payments made by HCFA to the UMWA plans during the base year. NCA contends that the Commissioner‘s reading of the word “reimburse,” which excludes an arrangement where a party is repaid on a capitated basis, is impermissibly restrictive. NCA argues that the agency reading of the statute is not entitled to defеrence because Congress has spoken to the precise issue in the plain language of the Act.
Any exercise of statutory interpretation begins first with the language of the act. Bailey v. United States, U.S. —, —, 116 S.Ct. 501, 506, 133 L.Ed.2d 472 (1995); Chevron, 467 U.S. at 842, 104 S.Ct. at 2781. Where the intent of Congress is expressed in the text of a statute in reasonably plain terms, we must give effect to that intent. Griffin v. Oceanic Contractors, Inc., 458 U.S. 564, 570, 102 S.Ct. 3245, 3250, 73 L.Ed.2d 973 (1982). Terms that are not defined in the statute, like the word “reimbursement” in this Act, are given their ordinary or natural meaning. Federal Deposit Ins. Corp. v. Meyer, — U.S. —, —, 114 S.Ct. 996, 1001, 127 L.Ed.2d 308 (1994).
We hold that the plain meaning of “reimbursement” in
The district court was correct in reasoning that the legislative history and genеral purpose of the Act do not overcome its plain statutory language. Although we consider the legislative history of a statute relevant in the process of interpretation, “we do not resort to legislative history to cloud a statutory text that is clear.” Ratzlaf v. United States, U.S. —, —, 114 S.Ct. 655, 662, 126 L.Ed.2d 615 (1994). Nor can a general appeal to statutory purpоse overcome the specific language of the Act, because the text of a statute is the most persuasive evidence of Congress‘s intent. Griffin, 458 U.S. at 571, 102 S.Ct. at 3250. Because the statutory text is clear, there is no need to address whether the Commissioner‘s reading of the statute is entitled to deference under Chevron. Chevron, 467 U.S. at 842-43, 104 S.Ct. at 2781.
The district court corrеctly held that the Secretary should have included the entire $182.3 million paid to the UMWA plans as “reimbursements.”
AFFIRMED.
CLARK, Senior Circuit Judge, Concurring Dubitante:
While I disagree with the holding of the majority, I nevertheless join for reasons which I shall explain. In a nutshell, it would be a disservice in 1996 to reverse a financial arrangement between the parties that has existed since 1993 and the partiеs have acted thereon. No one gets hurt in the short run if the Combined Fund for which the plaintiffs are partially responsible becomes overpaid.
The majority is correct in adopting from Webster the definition of “reimbursement” to mean “pay back” or “repay,” but in my view the opinion tends to err in saying: “The ordinary meaning of the term ‘reimbursement’ is not restricted by any requirement that such payments be dollar-for-dollar what the reimbursed party paid out.” While I would agree such would be the case if the excess reimbursement were penny ante, here we are talking about a reimbursement that exceeds twenty-five million dollars.
A report prepared by the majority staff оf the House Committee on Ways and Means during the 1994 Term of Congress1 convinces me that it would be an injustice to go back and try to recalculate the payments from 1993 to present. Although the report shows during the first six months of fiscal year 1995 the Combined Fund operated with a deficit of ten million dollars, the Fund had a surplus of ninety-six million dollars at the еnd of fiscal year 1994. Further, the report has this statement: “The existence of a surplus in the Combined Benefit Fund of over $100 million has generated considerable interest among the parties responsible for financing the retired miners’ health benefits.”2
From my view, this is a legislative problem, not a judicial one. I have confidence, pursuant to the legislation on the books, that the health benefits of the coal miners are protected. I have just as much confidence that the plaintiff coal mine operators will continue to be treated justly. I hope the taxpayers are equally protected.
This is a case in which to let sleeping dogs lie, and therеfore I concur.
CLARK
SENIOR CIRCUIT JUDGE
Notes
I. Reimbursement
Pursuant to waivers ... [T]he [UMWA plan(s)] will be reimbursed on a risk-based capitated payment basis for a period of 3 years, beginning July 1, 1990 and ending June 30, 1993. The [UMWA plan(s)] will furnish medical and other health services to its enrollees who are entitled to benefits under Part B of the Medicare program.
The capitation payment for the period beginning July 1, 1990 and ending June 30, 1991, will be $141.87 pеr member per month.... No reimbursement will be made to the [Combined Fund] for covered Part A and Part B services furnished by a provider of services.... (R. 2-28 Defs.’ Ex. 5.)