I. BACKGROUND
Plaintiffs are the States of Texas, Indiana, Kansas, Louisiana, Nebraska, and Wisconsin ("Plaintiffs"). Am. Compl. 1, ECF No. 19. Defendants are the United States of America (the "Government"); the United States Department of Health and Human Services ("HHS"); Alex Azar, in his official capacity as Secretary of HHS; the United States Internal Revenue Service (the "IRS"); and David Kautter, in his official capacity as Acting Commissioner of the IRS (collectively, "Defendants"). Id. at 1-2.
On February 24, 2016, Plaintiffs filed their amended complaint, alleging that Defendants, in violation of the Patient Protection and Affordable Care Act (the "ACA"), the Administrative Procedure Act (the "APA"), and the United States Constitution, required them to pay the ACA's Health Insurance Provider Fee (the "HIPF").Id. at 3-19. The ACA imposed the HIPF on medical providers but exempted the states from paying it. See Mar. 5, 2018 Mem. Op. & Order 1-9, ECF No. 88. Notwithstanding Congress's exemption of the states in the ACA, HHS enacted a regulation (the "Certification Rule") that empowered a private actuarial board to require Plaintiffs to account for the HIPF in payments to their respective managed care organizations ("MCOs")-the medical providers who contract with Plaintiffs to service their Medicaid recipients. See id. Plaintiffs' amended complaint challenged the legality and constitutionality of both the HIPF and the Certification Rule. See Am. Compl. 19-29, ECF No. 19.
Plaintiffs asserted ten counts in their amended complaint, claiming: (1) the HIPF violates Article I's Spending Clause and the Tenth Amendment, thereby entitling Plaintiffs to declaratory and injunctive relief (Counts I, IV, VI, VIII, IX, and X-collectively, the "HIPF claims"); (2) the Certification Rule violates Article I's Vesting Clause, the APA, and the ACA, thereby entitling Plaintiffs to declaratory relief (Counts II, III, and V-collectively, the "Certification Rule claims"); and (3) Plaintiffs are entitled to a tax refund of their HIPF payments under
On August 4, 2016, in an order considering a motion to dismiss, the Court dismissed the Tax Refund claim in Count VII. See Aug. 4, 2016 Mem. Op. & Order 18-21, ECF No. 34. The Court found that Plaintiffs were not entitled to a HIPF refund under
Next, on March 5, 2018, the Court granted partial summary judgment for Plaintiffs, finding Plaintiffs entitled to judgment as a matter of law on two of their Certification Rule claims in Count V, and finding Defendants entitled to judgment as a matter of law on all other counts except Count VII (which the Court previously dismissed). See Mar. 5, 2018 Mem. Op. & Order, ECF No. 88. Out of Plaintiffs' thirteen prayers for relief, the Court granted only declaratory relief, declaring the Certification Rule unlawful under both the Constitution and the APA. See
In its summary judgment order, the Court did not address whether Plaintiffs were entitled to equitable disgorgement. See Mar. 5, 2018 Mem. Op. & Order, ECF No. 88.
Because the Court has not yet entered final judgment in this case, the Court's August 4, 2016 Order dismissing Count VII, and its March 5, 2018 Order rendering summary judgment on all other counts, are both interlocutory. See FED. R. CIV. P. 54(b). Plaintiffs' instant motion moves the Court to: (1) reconsider its March 5, 2018 finding that the HIPF is a tax for purposes of the Anti-Injunction Act ("AIA"); (2) reconsider its March 5, 2018 Order declaring the Certification Rule unlawful but not disgorging Plaintiffs' past HIPF payments; (3) reconsider its August 4, 2016 dismissal of the Tax Refund claim in Count VII; and (4) enter a final judgment that includes a permanent injunction prohibiting Defendants from "impos[ing] liability for the [HIPF] upon Plaintiffs and their agencies." See Pls.' Mot. Recons., ECF No. 95; Prop. Final J., ECF No. 95-1. The Court construes Plaintiffs' motion for reconsideration as a motion to reconsider an interlocutory order under Rule 54(b).
Federal Rule of Civil Procedure 54(b)"allows parties to seek reconsideration of interlocutory orders and authorizes the district court to 'revise[ ] at any time' 'any order or other decision ... [that] does not end the action.' " Austin v. Kroger Texas, L.P. ,
"[T]he power to reconsider or modify interlocutory rulings [under Rule 54(b) ] 'is committed to the discretion of the district court,' and that discretion is not cabined by the 'heightened standards for reconsideration' governing final orders [under Rule 59(e) ]." Austin ,
III. ANALYSIS
Plaintiffs make four requests in their motion for reconsideration and entry of judgment. Plaintiffs ask the Court to reconsider: (1) its March 5, 2018 finding that the HIPF is a tax for purposes of the AIA; (2) its March 5, 2018 Order granting only declaratory relief under the Declaratory Judgment Act (the "DJA"), and not disgorgement of Plaintiffs' unlawful HIPF payments under the APA; and (3) its August 4, 2016 dismissal of the Tax Refund claim in Count VII. See generally Pls.' Mot. Recons., ECF No. 95. Plaintiffs also ask the Court to enter a final judgment that permanently enjoins Defendants from "impos[ing] liability for the [HIPF] upon Plaintiffs and their agencies." Prop. Final J., ECF No. 95-1. Applying the rubric of Rule 54(b), the Court considers each request in turn.
A. The HIPF is a "Tax" Under the AIA but a "Fee" Under the DJA and APA
Plaintiffs argue that while the HIPF may be a tax for constitutional purposes, the Court incorrectly found that the HIPF is a tax for purposes of the AIA, DJA, and APA. See Pls.' Mot. Recons. 2-4, ECF No. 95. Plaintiffs therefore ask the Court to reconsider its finding that the HIPF is a tax under the AIA and to instead find that the HIPF is a "fee" under the AIA, DJA, and APA. See id. Defendants do not respond to that argument. See generally Defs.' Resp., ECF No. 98.
To determine whether Congress intended the HIPF to be a "tax" or a "fee," the Court must begin with the text of the ACA, ascertaining its plain meaning by considering its language and design as a whole. See K Mart Corp. v. Cartier, Inc. ,
Sec. 9010. [ 26 U.S.C. 4001 note prec.] IMPOSITION OF ANNUAL FEE ON HEALTH INSURANCE PROVIDERS
(a) IMPOSITION OF FEE. - ...
(b) DETERMINATION OF FEE AMOUNT. -
(1) IN GENERAL. -With respect to each covered entity, the fee under this section for any calendar year ...
(3) SECRETARIAL DETERMINATION. -The Secretary shall calculate the amount of each covered entity's fee for any calendar year ...
(c) COVERED ENTITY. -
(1) IN GENERAL. -For purposes of this section, the term "covered entity" means any entity which provides health insurance for any United States health risk during the calendar year in which the fee under this section is due....
(d) TAX TREATMENT OF FEES. -The fees imposed by this section-
(1) for purposes of subtitle F of the Internal Revenue Code of 1986, shall be treated as excise taxes with respect to which only civil actions for refund under procedures of such subtitle shall apply, and(2) for purposes of section 275 of such Code shall be considered to be a tax described in section 275(a)(6)....
See
"Where Congress uses certain language in one part of a statute and different language in another, it is generally presumed that Congress acts intentionally." Nat'l Fed'n of Indep. Bus. v. Sebelius ,
With respect to the AIA, however, the Supreme Court held in NFIB that the AIA applies to an exaction that the enacting statute treats as a tax for purposes of the IRC. See NFIB ,
B. Plaintiffs Are Entitled to Equitable Disgorgement
Plaintiffs next argue they are entitled to equitable disgorgement of their HIPF payments under the APA, even if they are not entitled to a tax refund of those payments under
The Court begins by finding that it may properly grant Plaintiffs' request for equitable disgorgement on a Rule 54(b) motion even if Plaintiffs did not specifically request it in their summary judgment briefing. First, Plaintiffs' adequately pled equitable disgorgement. Plaintiffs' amended complaint includes a catch-all request for "such other and further relief to which [Plaintiffs] are justly entitled at law and in equity." See Am. Compl. 29, ECF No. 19. The Supreme Court has held that this form of catch-all pleading allows the district court to award any appropriate relief at law or in equity-including relief that the parties do not specifically request in subsequent briefing. Cf. Whole Woman's Health v. Hellerstedt , --- U.S. ----,
The Court next considers whether the APA waives sovereign immunity for Plaintiffs' request for disgorgement. The APA waives immunity for "relief other than money damages."
Therefore, Section 702 waives sovereign immunity for all equitable remedies that provide "specific" relief, but does not waive immunity for legal or equitable remedies that provide "substitute" relief. See Dep't of the Army v. Blue Fox, Inc. ,
Plaintiffs ask for disgorgement of their HIPF payments, characterizing their request as "specific" relief that gives them "the very thing to which [they are] entitled"-their HIPF funds. See Pls.' Mot. Recons. 12-15, ECF No. 95. Defendants respond that Plaintiffs actually seek "substitute" relief-the cash equivalent of their HIPF funds. See Defs.' Resp. 17-18, ECF No. 98 ("Nor do Plaintiffs seek the return of specific res (including money) that the federal government seized or otherwise obtained from them...."). According to Defendants, Plaintiffs have not shown that the specific dollar bills that they paid to their MCOs in their capitation rates to
In support of this argument, Defendants cite Modoc Lassen wherein the Tenth Circuit held that "the district court awarded the Tribes money damages when it ordered the Department of Housing and Urban Development ("HUD") to compensate them using funds from grant years other than the grant years during which HUD wrongfully collected the alleged overpayments." Modoc Lassen Indian Hous. Auth. v. U.S. Dep't of Hous. & Urban Dev. ,
Defendants also cite Diaz v. United States ,
The Court agrees with Defendants that ordering Defendants to disgorge Plaintiffs'
However, Plaintiffs alternatively request disgorgement of their HIPF funds as a means of enforcing the ACA's statutory mandate exempting states from paying the HIPF. See Pls.' Mot. Recons. 12-13, ECF No. 95 (arguing that the Court may order disgorgement to force an agency to "comply with a mandatory funding requirement"). Defendants respond that "Plaintiffs cannot point to any statute or regulation that entitles them to receive any specific funds from the federal government...." Defs.' Resp. 23, ECF No. 98. Plaintiffs reply that two statutes-the ACA, which exempts the states from paying the HIPF, and the APA, which waives sovereign immunity for specific relief-entitle them to recover their HIPF payments. See Pls.' Reply 4, ECF No. 99.
The Court finds that the APA and the ACA entitle Plaintiffs to disgorgement because the APA waives immunity for "a suit seeking to enforce [a] statutory mandate," and disgorgement in this case enforces Defendants' compliance with the ACA's mandate specifically exempting the states from paying the HIPF. Bowen ,
Here, Plaintiffs similarly request both disgorgement and injunctive relief to force Defendants to comply with the ACA's statutory exemption. See Am. Compl. 26-29, ECF No. 19. While the ACA does not explicitly command Defendants to disgorge HIPF monies improperly collected from the states-in the same way that the statute in Bowen stated that the government "shall pay" for Medicaid services-it does contain an exemption that explicitly prohibits Defendants from collecting the HIPF from the states in the first place. See Bowen ,
The Court may therefore exercise its inherent and broad equitable jurisdiction to order Defendants to disgorge Plaintiffs' HIPF monies in order to enforce the ACA's statutory mandate exempting the states from payment. Cf. Porter ,
Having found jurisdiction to consider Plaintiffs' disgorgement request, the Court finds that Plaintiffs are entitled to disgorgement of their HIPF payments. Defendants unlawfully required Plaintiffs to account for and pay the HIPF in their MCO capitation rates and have no right to retain those funds that properly belong to Plaintiffs. Indeed, the Court finds that this is a paradigmatic case for equitable relief. The Court dismissed Plaintiffs request for a tax refund due to a legal technicality: Plaintiffs were not "taxpayers" under the IRC because they "were neither directly subject to the HIPF, nor actually paid the relevant tax on behalf of the taxpayer assessed." Aug. 4, 2016 Mem. Op. & Order 21, ECF No. 34. Courts of equity exist for precisely these situations, to afford complete relief where a strict adherence to the text or precedent governing remedies at law prevents the plaintiff from fully recovering. The Court therefore GRANTS Plaintiff's motion to reconsider the Court's grant of declaratory relief without disgorgement.
C. Reconsidering Dismissed Count VII is Unnecessary
"[A] motion to reconsider under Rule 54(b)... requires the Court to determine whether reconsideration is necessary under the circumstances." Dallas Cnty. ,
D. Plaintiffs Are Not Entitled to a Permanent Injunction
Plaintiffs' proposed final judgment requests a permanent injunction against Defendants "impos[ing] liability for the [HIPF] upon Plaintiffs and their agencies." See Prop. Final J., ECF No. 95-1. "Any injunctive relief is considered an extraordinary and drastic remedy, not to be granted routinely, but only when the movant, by a clear showing, carries the burden of persuasion." Harris Cnty., Tex. v. CarMax Auto Superstores Inc. ,
The Fifth Circuit's decision in Chacon controls this case. Chacon v. Granata ,
The same presumption applies in this case. As detailed in the Court's March 5, 2018 Order on summary judgment, HHS enacted the Certification Rule, which empowered a private entity-the Actuarial Standards Board (the "ASB")-to require Plaintiffs to account and pay for the HIPF in their MCO capitation rates in order to receive Medicaid funds. See Mar. 5, 2018 Mem. Op. & Order 3-9, ECF No. 88. The ASB accomplished this by requiring Plaintiffs to conform to Actuarial Standard of Practice ("ASOP") 49, which declared that capitation rates must account for the HIPF in order to be "actuarially sound" under federal law. See id. at 8. Under the Certification Rule, HHS would only approve capitation rates certified by private actuaries as complying with ASOP 49. See id. at 41-43. In this way, HHS disobeyed the ACA's clear statutory command exempting the states from paying the HIPF. However, Plaintiffs have not shown that HHS will, going forward, refuse to approve future MCO capitation rates that do not account for the HIPF. In lieu of the Court's declaration that the Certification Rule is unlawful, the Court must assume that HHS will follow the law going forward. Plaintiffs have not rebutted that presumption.
Because Plaintiffs have not shown a substantial threat of irreparable injury, Plaintiffs have not carried their burden of establishing a need for permanent injunctive relief. The Court therefore DENIES Plaintiffs' request for a permanent injunction.
For the foregoing reasons, the Court GRANTS in part and DENIES in part Plaintiffs' motion for reconsideration and entry of judgment (ECF No. 95). The Court will issue a separate final judgment order pursuant to Federal Rule of Civil Procedure 58.
SO ORDERED on this 21st day of August, 2018 .
Notes
Plaintiffs requested equitable disgorgement in their amended complaint. See Am. Compl. 29, ECF No. 19 (praying for "such other and further relief to which [Plaintiffs] are justly entitled at law and in equity"). Moreover, in subsequent briefing related to the parties' motions for summary judgment, Plaintiffs clarified that they sought either "a refund or disgorgement" of their HIPF payments. Pls.' Opp. Defs.' Mot. Extend Time 4-5, ECF No. 60.
Plaintiffs style their motion as a "Motion ... to Reconsider the Court's Dismissal of Plaintiffs' Claims for Refunds And Other Rulings." Pls.' Mot. Recons., ECF No. 95. Though Plaintiffs do not specify whether they bring their motion under Rule 59(e) or Rule 54(b), Defendants concede that Plaintiffs bring their motion under Rule 54(b). See Defs.' Resp. 2-3, ECF No. 98.
In its March 5, 2018 Order, the Court observed that Plaintiffs themselves characterized the HIPF as a "tax" in their summary judgment briefing. See Mar. 5, 2018 Mem. Op. & Order 24 n.36, ECF No. 88. Here, the Court clarifies that Plaintiffs only characterized the HIPF as a tax for constitutional purposes and did not concede that the HIPF is a tax for purposes of the AIA, DJA, or APA. See Pls.' Reply Supp. Pls.' Mot. Summ. J. 12, ECF No. 66 ("Whether the HIPF is labeled a 'fee' or 'tax' by Congress, the AIA does not bar jurisdiction.").
Having so found, and for convenience, the Court referred to the HIPF as a tax throughout its March 5, 2018 Order. See generally Mar. 5, 2018 Mem. Op. & Order, ECF No. 88.
The DJA prohibits declaratory relief in cases "respect[ing] ... Federal taxes."
Notably, Plaintiffs clarified during the summary judgment phase of the litigation that they desired either "a refund or disgorgement"-albeit in briefing on a continuance motion. See Pls.' Opp. Defs.' Mot. Extend Time 4-5, ECF No. 60.
These holdings dovetail with the common law's conceptual distinction between replevin, "[a]n action for the repossession of personal property wrongfully taken or detained by the defendant," Replevin , Black's Law Dictionary (10th ed. 2014), and trover, "the recovery of damages for the conversion of personal property, the damages generally being measured by the property's value." Trover , Black's Law Dictionary (10th ed. 2014). While both were actions at law, replevin had a more equitable character, such that in "rare cases," plaintiffs would "seek equitable relief to secure return of a chattel" rather than pursue the common law writ of replevin. 1 Dan B. Dobbs , Law of Remedies § 5.17(1), at 917 (2d ed. 1993).
Nor have Plaintiffs shown that a future requirement to pay the HIPF would constitute irreparable harm. Because the Court has found that Plaintiffs are entitled to equitable disgorgement of their past HIPF payments, see supra Part III.B, Plaintiffs may petition for equitable disgorgement of any unlawfully coerced HIPF payments in the future.
