On December 14,1999, the State of Connecticut brought this suit for equitable relief in the United States District Court for the District of Connecticut against Physicians Health Services of Connecticut, Inc. (“PHS”), an insurance company offering managed care plans to Connecticut residents. The State seeks an order pursuant to Section 502(a)(3) of the Employment Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1182(a)(3),
1
enjoining the defendant PHS from using a drug “formulary” — a list of drugs preapproved by PHS for reimbursement — that allegedly prevents plan enrollees from receiving drugs prescribed for them by their physicians that are medically necessary or preferable to a comparable listed drug. Under § 1132(a)(3), “a participant, beneficiary, or fiduciary” may bring a civil action for equitable relief to redress violations of ERISA or the terms of an ERISA-regulated plan. The State asserts standing to sue in its capacity as
parens patriae,
and as the assignee of eight individual participants in PHS plans who have purportedly assigned to the State their right to seek “appropriate equitable relief” with respect to “any cause of action” they may have as plan participants or beneficiaries. Compl., Exs. 1-8 ¶ 2. The district court (Stefan R. Un-derhill,
Judge)
granted the defendant’s motion to dismiss the State’s complaint for lack of standing.
Connecticut v. Physicians Health Servs. of Conn., Inc.,
We conclude that the State as assignee of the plan participants’ rights to bring equitable actions against the defendant lacks standing under Article III of the Constitution. We further hold that the State cannot bring this suit in a
parens patriae
capacity. Because Congress “carefully drafted” § 1132, parties other than those explicitly named therein — plan participants, beneficiaries, and fiduciaries — may not bring suit.
Pressroom Unions-Printers League Income Sec. Fund v. Cont'l Assurance Co.,
BACKGROUND
In its complaint filed on December 14, 1999, the State alleges that PHS’s drug formulary system violates provisions of ERISA that impose on PHS: (1) a fiduciary duty to administer its health care plans solely in the interests of the plan participants; (2) a duty to disclose the full details of its plans to plan participants; and (3) a
*113
duty to provide plan participants with adequate notice of reasons for denials of claims for reimbursement. Compl. ¶¶ SB-90. The State asserts that PHS’s drug formulary system injures plan participants by denying them “access to safe, effective, and medically necessary” drugs prescribed by their doctors.
Id.
¶ 83. The details of the State’s allegations are set forth in the district court’s opinion.
See PHS,
Relying on 29 U.S.C. § 1182(a)(8), 2 which allows “a participant, beneficiary, or fiduciary” of an ERISA-regulated plan to bring a civil action for injunctive and other equitable relief, the State seeks an order:
1. requiring the defendant to provide its enrollees with the prescription medications ordered by the attending physician unless the defendant submits to the Court, and the Court approves, a plan for substituting the defendant’s preferred medications for those prescribed while insuring [sic] that (i) the substitution is approved by the attending physician, and (ii) the enrollee experiences no unreasonable delay before receiving an appropriate medication; and
2. ' requiring the defendant to comply with the dictates of ERISA and disclose to enrollees information sufficient to inform them fully and accurately, prior to their enrollment or re-enrollment in the plan, concerning the true nature of the prescription drug benefit to which they are entitled; and
3.requiring that whenever an enrollee requests coverage of a prescription drug by presenting a completed prescription form to a participating pharmacy and coverage is denied, the defendant shall give the enrollee a written denial notice setting forth the specific reason for the denial, and the steps necessary to file an appeal[.]
Compl. ¶ 91. The complaint also requests “[s]uch other and further relief as the Court may deem necessary and proper.” Id. 3
The State advances two theories of standing. First, it asserts standing as the assignee of the rights of eight plan participants as individuals and as representatives of a class consisting of all Connecticut residents enrolled in PHS’s managed care plans. Second, it asserts standing in its parens patriae capacity to protect its interest in the health and well-being of its citizens. Each of these plan participants executed a document purporting to assign to the State his or her right to sue for injunctive or other equitable relief pursuant to 29 U.S.C. § 1132(a)(3). The right to sue for money damages was not assigned and remains with the plan participants. Attached to the complaint are copies of these assignments. Each states:
I hereby assign to the State of Connecticut any cause of action I may have aris *114 ing from my status as a participant in or beneficiary of an employee welfare benefit plan established pursuant to the Federal Employee Retirement Income Security Act of 1974 (“ERISA”), upon the following conditions:
1. I believe my managed care organization has improperly and illegally obstructed my access to safe and effective prescription medications. I believe many other Connecticut residents have been injured in a similar way. I cannot afford to hire private attorneys to protect my rights under ERISA.
2. By this assignment I intend to empower the State of Connecticut, by and through the Attorney General, to take action to protect me, and people like me, pursuant to 29 U.S.C. § 1132(a)(3), which provides that I, or my assignee, may bring an action to enjoin any act or practice which violates the terms of my health care plan, or to obtain other appropriate equitable relief to redress such violations or to enforce provisions of ERISA or the plan. I agree to cooperate with the Attorney General’s Office in any such action, and I agree that the facts of my case should be made public. I am willing, if necessary, to testify under oath.
3. Any positive result the Attorney General is able to obtain will help me, and other people in my position, to receive the medically necessary prescription medications to which we are entitled and which are essential to our health and well-being.
Compl., Exs. 1-8. In exchange for this assignment, the State neither promised to prosecute the assignors’ claims nor provided other consideration.
On January 24, 2000, PHS filed a motion to dismiss the complaint pursuant to Rules 12(b)(1) and 12(b)(6) of the Federal Rules of Civil Procedure on the grounds that: (1) the State lacked standing to bring this action; (2) the assignor-plan participants had not suffered any injuries compensable under ERISA; and (3) the State failed to state a cause of action under ERISA. On July 13, 2000, the district court granted the defendant’s motion to dismiss, holding that the State lacked standing to pursue its claims either as
parens patriae
or as the assignee of the named participants— either individually or as representatives of a class.
PHS,
This appeal followed. The sole issue before us is whether the State has standing in either of the two capacities it asserted in the district court.
DISCUSSION
I. Standard of Review
Because “standing is challenged on the basis of the pleadings, we ‘accept as true all material allegations of the complaint, and must construe the complaint in favor of the complaining party.’ ”
United States v. Vazquez,
II. The State’s Standing as Assignee
We reach the same conclusion as that of the district court, that the State lacks standing to pursue this action as an assign-ee of the eight plan participants’ right to bring an action in equity, although our reasoning differs from the district court’s. The court concluded that the State lacks standing as an assignee because “the civil enforcement provisions of ERISA are exclusive and provide standing only to ... specifically enumerated” parties, who include plan participants and beneficiaries but not their assignees.
PHS,
The assignments purport to transfer to the State any right of action for equitable relief possessed by the plan participants by virtue of their status as plan participants or beneficiaries. They do not, the State acknowledges, confer “actual” rights or benefits under ERISA on the State. Pl.’s Br. at 15-17. The right to recover benefits or to seek money damages remains with the assignors. 6 Moreover, the *116 assignments divorce the equitable cause of action aimed at an alleged breach of fiduciary duty from the duty itself because they do not create a fiduciary duty running from PHS to the State. And the assignments do not shift the loss suffered by individual enrollees from the alleged breach of such duty from the individuals to the State.
“Whether a party has a sufficient stake in an otherwise justiciable controversy to obtain judicial resolution of that controversy is what has traditionally been referred to as the question of standing to sue.”
Sierra Club v. Morton,
Article III, § 2 of the United States Constitution restricts federal courts to deciding “Cases” and “Controversies.” From this has emerged the doctrine of constitutional standing. Federal courts must determine [standing] at the threshold of every case.... “It would violate principles of separation of powers for us to hear a matter that was not a case or controversy and therefore not delegated to the [federal] judiciary under Article III.”
Vt. Right to Life Comm., Inc. v. Sorrell,
At an “irreducible constitutional minimum,” Article III standing requires that the plaintiff “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.”
Lujan v. Defenders of Wildlife,
The State does not bring suit here as a party injured itself, but as an assignee of others who assert injury. The Supreme Court has held that in at least some cases, an “assignee of a claim [does have] standing to assert the injury in fact suffered by the assignor.”
Vt. Agency,
There are also situations where, even though an assignee incurs no injury, expense, or loss in exchange for the assignment, a valid ánd binding assignment of a
claim
(or a portion thereof) — not only the right or ability to bring suit — may confer standing on the assignee.
8
In
Vermont Agency,
the Supreme Court held that the plaintiff had standing under Article III to bring a
qui tarn
9
civil action pursuant to the False Claims Act, which allows a private person (the relator) to bring suit on behalf of the United States government and in return recover a share of the proceeds from the action.
The case before us differs critically from
Vermont Agency
and
I.V. Services.
The
qui tam
relator in the former and the healthcare provider in the latter each had a “ ‘concrete private interest in the outcome of [its] suit.’ ”
See Vt. Agency,
As assignee in the present case, however, the State fails to meet the injury requirement because it does not have a “concrete private interest in the outcome of the suit.”
See id.
(citation and internal quotation marks omitted). In other words, it has failed to allege that it suffered an “injury in fact” that is “particularized.”
See Lujan,
“We have no doubt about the sincerity of [the State’s] stated objectives and the depth of [its] commitment to them. But the essence of standing is not a question of motivation but of possession of the requisite ... interest that is, or is threatened to be, injured by the unconstitutional conduct.”
Valley Forge Christian Coll.,
III. The State’s Standing as Parens Patriae
A. Article III Standing
As an alternative basis for jurisdiction, the State asserts the right to institute this action in its capacity as
parens patri-ae.
The doctrine of
parens patriae
allows states to bring suit on behalf of their citizens in certain circumstances by asserting a “quasi-sovereign interest.”
Alfred L. Snapp & Son, Inc. v. Puerto Rico ex rel. Barez,
The district court, in concluding that the State had no Article III standing to bring this litigation, reviewed various factors that the Supreme Court, this Court, and others have viewed as prerequisites for
parens patriae
standing.
PHS,
We might be inclined to disagree with the district court were it necessary to address the issue of Article III parens patri-ae standing. 14 We do not think, however, that it is.
B. Statutory Standing
Whether or not the State has
parens patriae
standing under Article III, we conclude that it lacks statutory standing under ERISA’s § 1132(a)(3). When determining whether a state has
parens patriae
standing under a federal statute, we ask if Congress intended to allow for such standing.
See Hawaii v. Standard Oil Co. of Cal.,
Section 1132(a)(3) allows “a participant, beneficiary, or fiduciary” of an ERISA-regulated plan to bring a civil action for injunctive and equitable relief. Other sub-parts of § 1132 allow the Secretary of Labor to bring specified actions. Id. §§ 1132(a)(2), (4), (5), (8), (9). Section *121 1132(a)(7) authorizes states “to enforce compliance with a qualified medical child support order,” and § 1169(b) of the same title authorizes states to acquire the rights of third parties through assignment for the limited purpose of recouping payments made under state plans for medical assistance. Nowhere else in § 1132 are states authorized to bring suit.
Courts have consistently read § 1132(a)(3) as strictly limiting “the universe of plaintiffs who may bring certain civil actions.”
Harris Trust and Savs. Bank v. Salomon Smith Barney, Inc.,
Because states are not mentioned in § 1132(a)(3), Congress — which “carefully drafted [the] provisions” of § 1132 — did not intend for them to have the ability to bring suit pursuant to § 1132(a)(3).
See Pressroom Unions-Printers,
By holding that the State lacks
parens patriae
standing because § 1132(a)(3) does not expressly provide for such standing, we do not of course intend to imply that states may only sue in their
parens patriae
capacity when a statute specifically provides for suits by states. “[S]tates have frequently been allowed to sue in
parens patriae
to ... enforce federal statutes that ... do not specifically provide standing for state attorney generals.”
New York ex rel Vacco v. Mid Hudson Med. Group, P.C.,
*122 By our holding, we reject the State’s argument that Congress cannot limit states’ power to sue as parens patri-ae. Specifically, the State argues that “[t]he ability of states to act in the interest of their citizens in a parens patriae capacity is an essential attribute of the inherent sovereignty of states that may not be diminished in light of the principles of our federalism that are reflected in the Constitution and the Tenth Amendment.” Pl.’s Ltr. Br. of June 12, 2001, at 14.
The Tenth Amendment provides that “[t]he powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” Federal statutes validly enacted under one of Congress’s enumerated powers — here, the Commerce Clause — cannot violate the Tenth Amendment unless they commandeer the states’ executive officials,
see Printz v. United States,
CONCLUSION
For the foregoing reasons, the judgment of the district court is affirmed.
Notes
. ERISA is codified at 29 U.S.C. §§ 1001-1461. We refer to the provisions of ERISA as codified: § 502 of ERISA, for example, is referred to as 29 U.S.C. § 1132.
. Section 1132 provides in pertinent part:
(a) Persons empowered to bring a civil action
A civil action may be brought ...
(3) by a participant, beneficiary, or fiduciary (A) to enjoin any act or practice which violates any provision of this subchapter or the terms of the plan, or (B) to obtain other appropriate equitable relief (i) to redress such violations or (ii) to enforce any provisions of this subchapter or the terms of the plan....
29 U.S.C. § 1132(a)(3).
. In addition, the State seeks an order certifying this action as a class action on behalf of all Connecticut residents enrolled in PHS's managed care plans established under ERISA. Because the district court dismissed this action in its entirety, the State's March 30, 2000 motion for class certification was never ruled upon and is not at issue here.
.We have previously held that assignees have standing to sue under 29 U.S.C. § 1132(a) in some circumstances. For example, we have held that healthcare providers to whom a beneficiary has assigned his or her claim in exchange for healthcare have standing to sue under ERISA to recover for medical expenses incurred.
I.V. Servs. of Am., Inc. v. Trs. of Am. Consulting Eng’rs Council Ins. Trust Fund,
. We need not and therefore do not address the other issues raised by the defendant or amicus curiae, including: (1) whether ERISA bars assignments to state governments; (2) whether breach of fiduciary duty claims are personal and cannot be assigned; (3) whether a party can assign a cause of action without also assigning the underlying rights and benefits; and (4) whether the non-assignment clauses in the PHS plans bar these assignments.
. The assignments each begin by assigning to the State "any cause of action” arising under ERISA. See Compl., Exs. 1-8. The assignment is then qualified as being "upon the following conditions.” Id. The second paragraph thereafter reads, in pertinent part, "By this assignment I intend to empower the State of Connecticut, by and through the Attorney General, to take action to protect me, and people like me, pursuant to 29 U.S.C. 1132(a)(3), which provides that I, or my as- *116 signee, may bring an action to enjoin any act or practice which violates the terms of my health care plan, or to obtain other appropriate equitable relief to redress such violations or to enforce provisions of ERISA or the plan.” Id. ¶ 2. The State agrees that the intent of the parties was for the plan participants to assign only their right to such equitable relief and thus retain the right to seek payment of their benefits. See Pl.’s Br. at 15 (“Most important, the assignments exclude any claims for benefits. Instead, the assignments are limited to ‘any cause of action for equitable relief ....'") (emphasis in original; purporting to quote assignments); cf. Audiotape of Oral Argument, May 1, 2001 (To panel member's question, "But they are retaining the right to sue for those benefits. They are only giving you the right to pursue injunctive relief, right?” the State’s Attorney General responded, "They assigned the right to pursue injunctive relief. That is the only relief they sought." Answering a related question, he said, "The State of Connecticut has nothing but the right to sue and seek the relief that would protect these individuals from the abuses that we claim violate federal law.”).
. Article III standing also requires that there be "a causal connection between the injury and the conduct complained of” and that it is "likely ... that the injury will be redressed by a favorable decision.”
Lujan,
. Although the Supreme Court held that an "assignee of a claim has standing,”
Vt. Agency,
. The Court explained:
"Qui tarn
is short for the Latin phrase
qui tarn pro domino rege quam pro se ipso in hoc parte sequitur,
which means ‘who pursues this action on our Lord the King's behalf as well as his own.’ ” Vt.
Agency,
. The
Vermont Agency
Court’s analysis also depended heavily on the "long tradition of
qui tam
actions in England and the American Colonies,”
id.
at 774,
. The State as an assignee has no interests other than those assigned to it by the assignors. Put another way, the State, as assignee, has the same interests as any private citizen to which such rights had been assigned. Thus, when suing in its capacity as assignee, the State cannot rely on its parens patriae interest in the health and well-being of its citizens.
.In its complaint, the State repeatedly states that the enrollees were injured and that the enrollees would benefit from the lawsuit. See Compl. ¶ 3 (stating that the enrollees have suffered "real and immediate injury” that includes "unnecessary pain and suffering, delayed recovery, and out-of-pocket expenditure”); id. ¶ 5 (stating that the enrollees were injured); id. ¶91 (requesting that PHS "provide its enrollees with the prescription medications,” "disclose to enrollees" sufficient information, and "give the enrollee a written denial notice”) (emphases added).
. We do not base our holding on the State’s status as a state.
Cf. Hunt v. Wash. State Apple Adver. Comm’n,
Nor do we base our holding on the fact that the State is seeking equitable relief, not money damages. In some circumstances, an as-signee seeking solely injunctive relief has standing. We have no reason to doubt, for example, that a person assigned a claim with respect to tangible property would have standing to seek an injunction with respect to the care or custody of that property.
. First, it is not clear to us that the State seeks to impose state law on a field preempted by ERISA, rather than to enforce ERISA itself. The Supreme Court stated in
Alfred L. Snapp & Son, Inc.
that a characteristic of a valid
parens patriae
suit is that the asserted injury "is one that the State, if it could, would likely attempt to address through its sovereign lawmaking powers.”
Second, the State raises concerns that may be legitimate regarding the likelihood that individual enrollees could or would pursue litigation on the scale necessary to obtain the full relief to which the State thinks its citizens are entitled.
See, e.g., Maryland v. Louisiana,
