American Council of Life Insurers v. District of Columbia Health Benefit Exchange Authority

73 F. Supp. 3d 65, 2014 U.S. Dist. LEXIS 160038, 2014 WL 5893464
CourtDistrict Court, District of Columbia
DecidedNovember 13, 2014
DocketCivil Action No. 2014-1138
StatusPublished
Cited by5 cases

This text of 73 F. Supp. 3d 65 (American Council of Life Insurers v. District of Columbia Health Benefit Exchange Authority) is published on Counsel Stack Legal Research, covering District Court, District of Columbia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
American Council of Life Insurers v. District of Columbia Health Benefit Exchange Authority, 73 F. Supp. 3d 65, 2014 U.S. Dist. LEXIS 160038, 2014 WL 5893464 (D.D.C. 2014).

Opinion

MEMORANDUM OPINION

BERYL A. HOWELL, United States District Judge

This case raises a constitutional challenge to the funding mechanism enacted by the District of Columbia to continue the operations of the District of Columbia Health Benefit Exchange (the “D.C. Exchange”) beginning on January 1, 2015. The D.C. Exchange was established under the auspices of the Patient Protection and Affordable Care Act (“ACA”) to, inter alia, “[e]nable individuals and small employers to find affordable and easier-to-understand health insurance;” “[flacilitate the purchase and sale of qualified health plans;” “[r]educe ’ the number of uninsured;” and “[a]ssist individuals and groups to access programs, premium assistance tax credits, and cost-sharing reductions.” Health Benefit Exchange Authori *73 ty Establishment Act (“Establishment Act”), D.C. Code § 31-3171.02. Indeed, the D.C. Exchange currently facilitates access to health care for approximately 50,-000 residents of this jurisdiction. See Compl. ¶ 44, ECF No. 1. To ensure sufficient funding for the operations of the D.C. Exchange when, after December 31, 2014, all federal funding assistance ceases, the District passed two separate laws, the Health Benefit Exchange Authority Financial Sustainability Emergency Amendment Act of 2014 (the “Emergency Amendment Act” or “EAA”), D.C. Act 20-356, and the Health Benefit Exchange Authority Financial Sustainability Temporary Amendment Act of 2014 (“TAA”), D.C. Act 20-256, both of which authorize a Health Carrier Assessment (the “HC Assessment”) on health insurance issuers doing significant business in the District, even if those issuers do not participate, or sell products eligible for sale, on the D.C. Exchange. Id. ¶¶ 45-47.

The plaintiff, American Council of Life Insurers (“ACLI”), a trade association with approximately 300 member insurance companies operating throughout the United States, including the District of Columbia, filed this suit against the District of Columbia, the District of Columbia Health Benefit Exchange Authority (the “Authority”) and various D.C. government officials in their official capacities 1 (collectively, “defendants”), alleging that the Emergency Amendment Act violates multiple parts of the U.S. Constitution by authorizing imposition of the HC Assessment on the plaintiffs members when those members do not participate in, or receive any benefit from, the D.C. Exchange. 2 See Compl. at 22 (“Plaintiff *74 prays for relief ... [t]hat the Court declare that the Emergency Legislation, as construed by the Authority, is unconstitutional and is preempted by the ACA and is thus unenforceable”). The plaintiff has moved, twice, to enjoin preliminarily the defendants from assessing and collecting the HC Assessment on premiums or other receipts from products that are not sold on the D.C. Exchange, see Compl., ¶ 88; Pl.’s Mot. for Prelim. Inj. (“Pl.’s P.I. Mot.”), ECF No. 11; Pl.’s Emergency Mot. for Prelim. Inj. (“Pl.’s P.I. Emerg. Mot.”), ECF No. 32, and the defendants have moved to dismiss the Complaint, under Federal Rule of Civil Procedure 12(b)(6), for failure to state a claim upon which relief can be granted, Defs.’ Mot. to Dismiss (“Defs.’ Mot.”), ECF No. 25. As discussed more fully below, the defendants’ motion is granted, the plaintiffs motions are denied, and the Complaint is dismissed.

I. BACKGROUND

The plaintiff claims that the HC Assessment on health insurance companies, which do not participate in, or sell products eligible for sale on, the D.C. Exchange, is preempted by the ACA and violates the Takings, Equal Protection and Due Process Clauses of the Fifth Amendment to the U.S. Constitution, as well as the non-delegation doctrine. Evaluation of these constitutional challenges is aided by review of pertinent provisions in the ACA and the Establishment Act, which is the law containing both the amendments — the Emergency Amendment and the TAA (the “Challenged Amendment”) that is at issue. This statutory review is followed by a summary of the procedural history of this case.

A. The Relevant Statutes

1. The ACA

The ACA was enacted to “increase the number of Americans covered by health insurance and decrease the cost of health care.” Nat’l Fed’n of Indep. Bus. v. Sebelius (NFIB), — U.S. -, 132 S.Ct. 2566, 2580, 183 L.Ed.2d 450 (2012). To this end, the law requires that (1) States create their own Exchange in compliance with federal regulations or that (2) the Secretary create a federally-managed program (a “Federal Exchange”) in the State. Compl. ¶¶ 1, 28. Only those health insurance plans that meet certain minimum requirements established by federal law are eligible for' sale as Qualified Health Plans (“QHPs”) on either State or Federal Exchanges. Generally, QHPs are comprehensive health plans that offer “essential health benefits” and meet other federal and state regulatory standards. Id. ¶ 30 (citing 42 U.S.C. § 18031(a)-(d)). Plans that do not meet these requirements, called “Excepted Plans,” are prohibited from sale on Exchanges. Compl. ¶ 26. Excepted plans include disability income, worker’s compensation policies, longterm care coverage, fixed indemnity insurance, *75 and certain group health insurance policies. Id. (citing 42 U.S.C. § 300gg-91(c)).

The ACA authorizes initial federal funding to the States and the District for the purpose of establishing State Exchanges. Id. ¶¶ 3, 43. In total, the initial federal funding provided to the States and the District to set up State Exchanges exceeded $4.8 billion. See Pl.’s Mem. in Supp. of Prelim. Inj. Mot. (“Pl.’s P.I. Mem.”), at 8 (citing Daniel H. Schlueter Decl. (“Schlueter Decl.”) Ex. D, Annie L. Mach, et al., Cong. Research Serv., R43066, Federal Funding For Health Insuranoe Exchanges 4-5 (2014), ECF No. 11-1). All federal funding for State Exchanges ceases, however, after December 31, 2014, at which time the States are expected to operate their Exchanges without federal funding. See id.

The same ACA provision, Section 1311(d)(5)(A), 42 U.S.C. § 18031(d)(5)(A), both terminates federal funding assistance “beginning January 1, 2015” and directs States to take responsibility for the “continued operations” of State Exchanges. This ACA provision is the lynehpin to the plaintiff’s preemption challenge. See id. ¶¶ 3, 29.

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Bluebook (online)
73 F. Supp. 3d 65, 2014 U.S. Dist. LEXIS 160038, 2014 WL 5893464, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-council-of-life-insurers-v-district-of-columbia-health-benefit-dcd-2014.