Hammer v. U.S. Dep't of Health & Human Servs.

905 F.3d 517
CourtCourt of Appeals for the Seventh Circuit
DecidedSeptember 25, 2018
Docket18-2523
StatusPublished
Cited by37 cases

This text of 905 F.3d 517 (Hammer v. U.S. Dep't of Health & Human Servs.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hammer v. U.S. Dep't of Health & Human Servs., 905 F.3d 517 (7th Cir. 2018).

Opinion

St. Eve, Circuit Judge.

The Department of Health and Human Services owed millions of dollars to the now-defunct Land of Lincoln Mutual Health Insurance Company. Likewise, Land of Lincoln owed millions to HHS. As part of its regulatory oversight, HHS has elected to set off its own debt payments by first paying down Land of Lincoln's debt. The Director of the Illinois Department of Insurance, who is Land of Lincoln's appointed liquidator, contends that this setoff violates an order issued by the Illinois court overseeing the liquidation proceedings that prevents any creditors from setting off money owed to Land of Lincoln without prior leave of the court. The Director asked the state court for a declaration that HHS violated the order, but HHS removed the motion to federal district court arguing that the federal government was not subject to the state court's jurisdiction. The district court remanded the case back to state court relying on a narrow reading of 28 U.S.C. § 1442 , as well as principles of abstention. We reverse on both grounds and remand to the district court for further proceedings consistent with this opinion.

I

This case centers on debts in the Affordable Care Act's three premium-stabilization programs-the Risk Adjustment, Risk Corridor, and Reinsurance programs-all of which were designed to redistribute money among insurance companies and thereby mitigate each company's exposure to risks in the market. See 42 U.S.C. §§ 18061 - 18063. For the purposes of this appeal, the parties broadly agree that HHS intended to implement these programs in a budget-neutral way paying out only the funds that each program had taken in from other insurance companies.

Land of Lincoln participated in these premium-stabilization programs and incurred a debt of roughly $32 million in the Risk Adjustment program. This debt, though large, should not have been a problem for the company, as HHS owed Land of Lincoln over $70 million, the bulk of which it owed under the Risk Corridor program. The government, however, was not able to pay what it owed because it was taking in far less money than it had expected, and it refused to dip into its limited discretionary funds. Like other insurance companies, Land of Lincoln sought the overdue Risk Corridor payments in a suit with the Court of Federal Claims, but it was rebuffed, Land of Lincoln Mut. Health Ins. Co. v. United States , 129 Fed. Cl. 81 (2016), and the Federal Circuit affirmed the dismissal of the claim in Land of Lincoln Mut. Health Ins. Co. v. United States , 892 F.3d 1184 (Fed. Cir. 2018), and its companion case Moda Health Plan, Inc. v. United States , 892 F.3d 1311 (Fed. Cir. 2018). By late 2016, Land of Lincoln was incapable of paying its Risk Adjustment debt, and thus became insolvent and began rehabilitation proceedings that turned into a liquidation.

As part of the liquidation, the Chancery Division of the Circuit Court of Cook County-one of two Illinois courts empowered to oversee insurance rehabilitation and liquidation, see 215 ILCS 5/199 -entered an order naming the Director of the Illinois Department of Insurance as liquidator, see 215 ILCS 5/191, and prohibited all of Land of Lincoln's creditors, including any "governmental entity," from "setting off or netting monies owed Land of Lincoln without the prior leave of this Court." See 215 ILCS 5/189. Despite this order and the Director's protestations, HHS began to offset its overdue payments against Land of Lincoln's debt in the Risk Adjustment program, as its own regulations permitted, see 45 C.F.R. § 156.1215 (b). HHS has since withheld $27 million in payments that it put toward Land of Lincoln's debt.

HHS's refusal to comply led the Director to move the state court for a declaratory judgment finding that HHS was in violation of the court's order. In the motion, the Director asserted that she "is not asking at this point that [HHS] be ordered to release the funds or pay them over to the estate," and instead she hoped that the declaration would lead HHS to follow the order of its own accord. In the event HHS did not choose to comply, the Director expressly asked for "leave to seek an appropriate remedy."

HHS removed the Director's motion to the United States District Court for the Northern District of Illinois under the federal officer removal statute, 28 U.S.C. § 1442 , that permits "[t]he United States or any agency thereof" to remove a "civil action ... that is commenced in a State court and that is against or directed to" the agency. Because the full liquidation proceeding in the Chancery Division of the Circuit Court of Cook County was not removable, HHS relied on § 1442(d)(1), which permits an agency to remove, separate from the entire case, "any proceeding (whether or not ancillary to another proceeding) to the extent that in such proceeding a judicial order, including a subpoena for testimony or documents, is sought or issued." Shortly after removal, HHS filed a Federal Rule of Civil Procedure 12(b)(1) motion to dismiss under the doctrine of "derivative jurisdiction," see Rodas v. Seidlin , 656 F.3d 610 , 615-16 (7th Cir. 2011), arguing that the state court lacked jurisdiction over the United States. In its motion, HHS argued that because the United States had not waived its sovereign immunity, the federal court could not hear the case except as an original suit. The Director responded by moving to remand the case back to state court.

The district court granted the Director's motion to remand.

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905 F.3d 517, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hammer-v-us-dept-of-health-human-servs-ca7-2018.