Optimal Wireless LLC v. IRS

77 F.4th 1069
CourtCourt of Appeals for the D.C. Circuit
DecidedAugust 8, 2023
Docket22-5121
StatusPublished
Cited by2 cases

This text of 77 F.4th 1069 (Optimal Wireless LLC v. IRS) is published on Counsel Stack Legal Research, covering Court of Appeals for the D.C. Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Optimal Wireless LLC v. IRS, 77 F.4th 1069 (D.C. Cir. 2023).

Opinion

United States Court of Appeals FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued February 9, 2023 Decided August 8, 2023

No. 22-5121

OPTIMAL WIRELESS LLC, APPELLANT

v.

INTERNAL REVENUE SERVICE, ET AL., APPELLEES

Appeal from the United States District Court for the District of Columbia (No. 1:20-cv-02297)

Jason B. Freeman argued the cause and filed the briefs for appellant. Kodie P. Bennion and Glen E. Frost entered appearances.

Ellen P. DelSole, Attorney, U.S. Department of Justice, argued the cause for appellees. With her on the brief were Francesca Ugolini and Geoffrey J. Klimas, Attorneys.

Before: SRINIVASAN, Chief Judge, WILKINS, Circuit Judge, and TATEL, Senior Circuit Judge.

Opinion for the Court filed by Chief Judge SRINIVASAN. 2 SRINIVASAN, Chief Judge: The Affordable Care Act obligates large employers to provide their full-time employees with health insurance coverage meeting certain requirements. If an employer fails to provide coverage or provides noncomplying coverage, it is liable for an exaction under 26 U.S.C. § 4980H.

In 2019, the Internal Revenue Service sent two letters proposing exactions under Section 4980H to appellant Optimal Wireless, a wireless communications company. Optimal then filed an action against the IRS and the Department of Health and Human Services, claiming that the agencies had failed to satisfy certain procedural requirements before imposing the proposed exactions. Optimal sought a declaratory judgment and an injunction barring the IRS from collecting any money without complying with those procedures.

The district court dismissed Optimal’s suit for lack of jurisdiction. The court held that an exaction under Section 4980H is a “tax” for purposes of the Anti-Injunction Act, which strips courts of jurisdiction over suits having the “purpose of restraining the assessment or collection of any tax.” 26 U.S.C. § 7421(a). We agree with the district court.

I.

A.

The Patient Protection and Affordable Care Act (ACA) “aims 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, 567 U.S. 519, 538 (2012) (NFIB). The ACA contains both an individual mandate and an employer mandate. 3 The individual mandate “requires most Americans to maintain ‘minimum essential’ health insurance coverage.” Id. at 539 (quoting 26 U.S.C. § 5000A). Many people obtain the required coverage through their employer. Id. A person who does not comply with the individual mandate must pay a “[s]hared responsibility payment” to the federal government. Id. (alteration in original) (quoting 26 U.S.C. § 5000A(b)). The Supreme Court upheld the individual mandate in NFIB as a constitutional exercise of Congress’s power to tax. Id. at 574. Congress, though, later “effectively nullified the penalty by setting its amount at $0.” California v. Texas, 141 S. Ct. 2104, 2112 (2021) (citing 26 U.S.C. § 5000A(c)).

To facilitate compliance with the individual mandate’s requirement for Americans to obtain health insurance, the ACA also imposes obligations upon employers. The employer mandate, which is at issue in this case, requires “large employer[s]” to give full-time employees “the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan.” 26 U.S.C. § 4980H(a)(1), (b)(1)(A). A “large” employer is an employer that had an average of at least fifty full-time employees in the preceding year. Id. § 4980H(c)(2)(A).

The employer mandate is backed by exactions imposed against noncomplying employers. Id. § 4980H(a)–(b). To avoid incurring an exaction, employers must do more than just offer minimum essential coverage. First, they must provide an “affordable” health care option, defined by reference to the applicable taxpayer’s household income. See id. § 36B(c)(2)(C)(i)(II). Second, they must offer a plan providing “minimum value,” defined as a plan covering 60 percent or more of the total allowed costs. See id. § 36B(c)(2)(C)(ii). 4 If an employer fails to provide coverage meeting those requirements (or fails to provide coverage altogether), its employees may be eligible to receive a premium tax credit or cost-sharing reduction, mechanisms the ACA established to defray the costs of health insurance and health care. See id. § 36B (premium tax credits); 42 U.S.C. § 18071 (cost-sharing reduction). And if an employee claims a premium tax credit or cost-sharing reduction, thus denoting a failure by her employer to provide the requisite coverage, her employer is subject to one of two exactions imposed by subsections (a) and (b) of Section 4980H.

First, under Section 4980H(a), an employer is liable for an exaction if it “fails to offer to its full-time employees (and their dependents) the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan . . . for any month.” 26 U.S.C. § 4980H(a)(1). Under that provision, an employer is subject to “an assessable payment equal to the product of the applicable payment amount [of 1/12 of $2,000] and the number of individuals employed . . . as full-time employees during such month.” Id. § 4980H(a), (c)(1).

Second, under Section 4980H(b), an employer is liable for an exaction if it does “offer[] to its full-time employees (and their dependents) the opportunity to enroll in minimum essential coverage” but an employee is still certified as having received a premium tax credit or cost-sharing reduction. Id. § 4980H(b). (That can occur if the offered coverage is unaffordable or inadequate in value.) In that case, an employer is subject to “an assessable payment equal to the product of the number of full-time employees” having received such certification “and an amount equal to 1/12 of $3,000.” Id. § 4980H(b)(1). The statute also provides that an exaction under Section 4980H(b) cannot exceed the maximum possible exaction under Section 4980H(a). See id. § 4980H(b)(2). 5

Section 4980H(a) thus differs from Section 4980H(b) in two ways. First, Section 4980H(a) applies when an employer does not provide minimum essential coverage at all, whereas Section 4980H(b) applies when the employer offers coverage but that coverage fails to qualify as affordable or as providing minimum value. Second, Section 4980H(a)’s exaction amount is a function of the employer’s total number of full-time employees, whereas Section 4980H(b)’s exaction amount is a function of only the number of employees certified as having received a premium tax credit or cost-sharing reduction.

B.

Because the district court resolved this case on a motion to dismiss the complaint, we take as true the factual allegations in Optimal’s complaint. Sparrow v. United Air Lines, Inc., 216 F.3d 1111, 1113 (D.C. Cir. 2000).

Optimal provides wireless communications services and products in Texas, New Mexico, Oklahoma, and Louisiana.

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77 F.4th 1069, Counsel Stack Legal Research, https://law.counselstack.com/opinion/optimal-wireless-llc-v-irs-cadc-2023.