Health Republic Insurance Company v. United States

United States Court of Federal Claims·Decided September 16, 2021·No. 16-259·Published

Opinion

IN THE UNITED STATES COURT OF FEDERAL CLAIMS ___________________________________ ) HEALTH REPUBLIC INSURANCE ) COMPANY, ) ) Plaintiff, ) ) v. ) No. 16-cv-259C ) THE UNITED STATES, ) ) Defendant. ) ___________________________________ ) ) COMMON GROUND HEALTHCARE ) COOPERATIVE, ) ) Plaintiff, ) ) v. ) No. 17-cv-877C ) THE UNITED STATES, ) ) Filed: September 16, 2021 Defendant. ) ___________________________________ )

OPINION AND ORDER Before the Court are Class Counsel Quinn Emanuel Urquhart & Sullivan LLP’s Motions

for Approval of Attorney’s Fee Request and Class Representative Incentive Award related to their

representation of certain classes certified in the above-captioned cases. See Health Republic ECF

No. 84; Common Ground ECF No. 107. 1 Class Counsel seek approval of an attorney’s fee award

of five percent, approximately $185 million of the combined $3.7 billion judgment recovered on

the Non-Dispute Subclasses’ risk corridors claims. They also seek approval of $100,000 incentive

awards to both Health Republic Insurance Co. (“Health Republic”) and Common Ground

1 Because the briefing pertaining to the opposed fee request motions in both cases is substantively the same, for ease of reference this opinion and order will cite only to the briefing in Health Republic. Healthcare Cooperative (“Common Ground”) (collectively, “named Plaintiffs”) as representatives

of their respective classes, to be paid from Class Counsel’s fee. The Court is tasked with

determining the reasonableness of these awards. For the reasons that follow, the Court approves

in part and denies in part Class Counsel’s requests.

I. BACKGROUND

On February 24, 2016, Class Counsel filed a complaint on behalf of Health Republic as the

first challenge to the Government’s failure to make risk corridors payments to Qualified Health

Plan (“QHP”) issuers pursuant to Section 1342 of the Patient Protection and Affordable Care Act,

Pub. L. No. 111-148 (2010), 124 Stat. 119, and the Health Care and Education Reconciliation Act

of 2010, Pub. L. No. 111-152 (2010), 124 Stat. 1029 (collectively, the “ACA”). See Pl.’s Class

Action Compl., Health Republic ECF No. 1. The risk corridors program was designed to mitigate

risk for QHP issuers participating in the new insurance market created by the ACA. It did so by

providing QHP issuers compensation from the Government for any “losses exceed[ing] a certain

defined amount due to high utilization and high medical costs,” while on the other hand requiring

QHP issuers to pay the Government “a percentage of any profits [QHP issuers] made over

similarly-defined amounts.” Id. ¶ 5. In the Complaint, Class Counsel argued on behalf of Health

Republic and a putative class of QHP issuers that Section 1342 was a money-mandating statutory

provision that required the Government to “pay any QHP certain amounts exceeding the target

costs they incurred in [benefit years] 2014 and 2015,” id. ¶ 60, notwithstanding Congress’s

decision not to appropriate sufficient funds to pay such amounts, id. ¶ 10. Health Republic was

the first lawsuit filed challenging the Government’s withholding of risk corridors payments and

the first of its kind to raise a money-mandating theory of recovery under the Tucker Act. Health

Republic ECF No. 84 at 9 (citing Decl. of Stephen A. Swedlow ¶ 8, ECF No. 84-1).

2 By August 2016, numerous other firms had brought similar suits in this court on behalf of

individual QHP issuers, each arguing, among other things, that Section 1342 mandated the

Government to make risk corridors payments. See, e.g., First Priority Life Ins. Co. v. United

States, No. 16-cv-587 (Fed. Cl.) (filed May 17, 2016); Moda Health Plan, Inc. v. United States,

No. 16-cv-649 (Fed. Cl.) (filed June 1, 2016); Blue Cross and Blue Shield of N.C. v. United States,

No. 16-cv-651 (Fed. Cl.) (filed June 2, 2016); Me. Cmty. Health Options v. United States, No. 16-

cv-967 (Fed. Cl.) (filed Aug. 9, 2016); see also Health Republic ECF No. 84-1 ¶ 11.

The Government moved to dismiss Health Republic’s Complaint, arguing that the Court

of Federal Claims lacked subject matter jurisdiction under the Tucker Act because Section 1342

did not constitute a money-mandating statute providing a substantive right to payment. See Def.’s

Mot. to Dismiss at 21–26, Health Republic ECF No. 8. The court rejected that argument and

denied the Motion to Dismiss as to the Section 1342 claim. See Health Republic Ins. Co. v. United

States, 129 Fed. Cl. 757 (2017).

At the same time the court was considering the Government’s Motion to Dismiss, Health

Republic was moving forward in the class certification phase. The Government did not oppose

certification; consequently, on January 3, 2017, the court certified the proposed class in Health

Republic and appointed Quinn Emanuel lead class counsel. Order at 1–2, Health Republic ECF

No. 30. On February 24, 2017, exactly one year after it initiated suit, the court granted Class

Counsel’s proposed class notice plan. See Order, Health Republic ECF No. 42. Consistent with

the opt-in nature of class actions in the Court of Federal Claims, Class Counsel’s notice explicitly

informed potential class members that they must affirmatively submit a Class Action Opt-In Notice

Form to join the class, otherwise they would receive no benefit from the lawsuit. Updated

Proposed Class Notice at 2, 5, Health Republic ECF No. 41-1. The notice advised potential class

3 members that, if successful, Class Counsel would seek permission to be compensated for their

representation, which would be deducted from the amount of any recovery by the class. Id. at 7.

It did not identify a particular amount or percentage of any proposed fee award. See id.; see also

Health Republic ECF No. 84-1 ¶ 13.

According to Class Counsel, it later became known that potential class members were

under the erroneous assumption that Class Counsel would be seeking a fee percentage in the

ballpark of 30 percent of any judgment. Mot. to Suppl. Class Notice at 1, Health Republic ECF

No. 50; Health Republic ECF No. 84-1 ¶ 13. To assuage those concerns, and with the court’s

approval, Class Counsel distributed a supplement to the class notice representing to potential class

members that they would seek a fee of no more than five percent of the class’s recovery. Proposed

Suppl. Class Notice at 6, Health Republic ECF No. 50-1; Order, Health Republic ECF No. 51;

Health Republic ECF No. 84-1 ¶ 15. The supplemental notice advised that the maximum award

may be substantially reduced depending on the level of class participation and, in any event, would

“be determined by the Court subject to, among other things, the amount at issue in the case and . .

. a ‘lodestar cross-check[.]’” Health Republic ECF No. 50-1 at 6. In sum, 153 QHP issuers opted

into the Health Republic class. Health Republic ECF No. 84-1 ¶ 17.

In March 2017, Health Republic moved for summary judgment. See Pl.’s Mot. for Summ.

J., Health Republic ECF No. 47. On June 27, 2017, before the court decided that Motion, Class

Counsel filed a separate class action complaint in Common Ground for benefit year 2016. See

Pl.’s Class Action Compl., Common Ground ECF No. 1. As in Health Republic, the court certified

the proposed risk corridors class in Common Ground and appointed Quinn Emanuel as class

counsel. Order at 2, 3, Common Ground ECF No. 17. It likewise approved Class Counsel’s

proposed class notice plan. Order, Common Ground ECF No. 25.

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