Persico v. Sebelius

919 F. Supp. 2d 622, 2013 WL 228200, 2013 U.S. Dist. LEXIS 8993
CourtDistrict Court, W.D. Pennsylvania
DecidedJanuary 22, 2013
DocketCase No. 1:12-cv-123-SJM
StatusPublished
Cited by6 cases

This text of 919 F. Supp. 2d 622 (Persico v. Sebelius) is published on Counsel Stack Legal Research, covering District Court, W.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Persico v. Sebelius, 919 F. Supp. 2d 622, 2013 WL 228200, 2013 U.S. Dist. LEXIS 8993 (W.D. Pa. 2013).

Opinion

MEMORANDUM OPINION

SEAN J. McLAUGHLIN, District Judge.

Following the enactment of the Affordable Care Act (or “ACA”) in March of 2010, group health plans and health insurance issuers not otherwise grandfathered under the Act are required to provide coverage for certain preventive health services — including FDA approved “contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity” — without cost sharing. Plaintiffs in this lawsuit— the Roman Catholic Diocese of Erie (the “Diocese”), the Most Reverend Lawrence T. Pérsico (as Bishop and Trustee of the Diocese), the St. Martin Center, Inc., and the Prince of Peace Center, Inc. — have sought to invalidate and enjoin this regulation (hereinafter referred to as the “Mandate”) on the grounds that it violates the Plaintiffs’ rights under the First Amendment, the Religious Freedom and Restoration Act, and the Administrative Procedures Act. Named as Defendants are the Secretaries of the U.S. Departments of Health and Human Services, Labor, and Treasury as well as the Departments themselves. This Court has jurisdiction over the matter pursuant to 28 U.S.C. §§ 1331, 1343(a)(4), and 1346(a)(2).

Presently pending before the Court is the Defendants’ motion to dismiss this action for lack of standing and/or ripeness. Plaintiffs have filed a memorandum in opposition to this motion, which is supported by various exhibits.1 The matter has been fully briefed and argued and is ripe for disposition.

I. STANDARD OF REVIEW

Defendants’ motion to dismiss for lack of jurisdiction, filed pursuant to Rule 12(b)(1) of the Federal Rules of Civil Procedure, concerns the Court’s “very power to hear the case.” Petruska v. Gannon Univ., 462 F.3d 294, 302 (3d Cir.2006) (citation omitted). Our Court of Appeals has explained that “there are two types of Rule 12(b)(1) motions: those that attack the complaint on its face and those that attack subject matter jurisdiction as a matter of fact. When considering a facial attack, ‘the Court must consider the allegations of the complaint as true,’ and in that respect such a Rule 12(b)(1) motion is similar to a Rule 12(b)(6) motion.” Id., at 302 n. 3 (citation omitted). A factual attack, on the other hand,

differs greatly for here the trial court may proceed as it never could under 12(b)(6) or Fed.R.Civ.P. 56. Because at issue in a factual 12(b)(1) motion is the trial court’s jurisdiction ... there is substantial authority that the trial court is free to weigh the evidence and satisfy itself as to the existence of its power to [625]*625hear the case. In short, no presumptive truthfulness attaches to plaintiffs allegations, and the existence of disputed material facts will not preclude the trial court from evaluating for itself the merits of jurisdictional claims. Moreover, the plaintiff will have the burden of proof that jurisdiction does in fact exist.

Id. at 302 n. 3 (citation omitted) (ellipsis in the original).

Here, the parties are in agreement that the Defendants’ jurisdictional challenge should be treated as a factual challenge, albeit one in which Plaintiffs’ factual averments stand largely unrebutted. Both sides further agree that Plaintiffs bear the burden of establishing this Court’s jurisdiction and, therefore, standing and ripeness. We proceed accordingly.

II. LEGAL BACKGROUND

The provision being challenged in this lawsuit is, as one court has stated, “the result of a complex history of Congressional legislation and agency rulemaking involving the Departments of Labor (‘DoL’), the Department of the Treasury (‘DoT’), and the Department of Health and Human Services (‘HHS’) (collectively, the ‘Departments’).” The Roman Catholic Archdiocese of New York v. Sebelius, 907 F.Supp.2d 310, 313, 2012 WL 6042864 at *1 (E.D.N.Y. Dec. 4, 2012). Because the U.S. District Court for the Eastern District of New York has aptly summarized the relevant legal history of the so-called “mandate provision” as it pertains to the issues in this case, we quote liberally from the Court’s decision in Roman Catholic Archdiocese of New York v. Sebelius:

In March 2010, Congress enacted the ACA as well as the Health Care and Education Reconciliation Act. These acts established a number of requirements relating to “group health plans,” a term which encompasses employer plans that provide health care coverage to employees, regardless of whether the plans are insured or self-insured. See 42 U.S.C. § 300gg-91(a)(1); Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventative Services Under the Patient Protection and Affordable Care Act, 75 Fed.Reg. 41,726, 41,727 (July 19, 2010) (“Interim Final Rules”). As is relevant here, the ACA requires that group health plans provide coverage for a number of preventative medical services at no charge to the patient. § 300gg-13. Specially, the ACA provides that a group health plan must “at a minimum provide coverage for and shall not impose any ' cost sharing requirements for[,]” among other things, women’s “preventative care and screenings ... as provided for in comprehensive guidelines supported by the' Health Resources and Services Administration[.]” § 300gg-13(a)(4).
The ACA’s preventative services coverage requirement does not, however, apply to group health plans that are grandfathered. See 42 U.S.C. § 18011(a)(2). A group health plan is grandfathered when at least one person was enrolled in the plan on March 23, 2010 and the plan has continually covered at least one individual since that date. See 26 C.F.R. § 54.9815-1251T(a)(1)(i)(DoT); 29 C.F.R. § 2590.715-1251(a)(1)(i)(DoL); 45 C.F.R. § 147.140(a)(1)(i)(HHS). A plan may lose its grandfathered status, however, if, when compared to the terms of the plan as of March 23, 2010, it eliminates benefits, increases a percentage cost-sharing requirement, significantly increases a fixed-amount cost-sharing [626]*626requirement, significantly decreases an employer’s contribution rate, or imposes or lowers an annual limit on the dollar value of benefits. See 26 C.F.R. § 54.9815-1251T(g)(1)(DoT); 29 C.F.R. § 2590.715 — 1251(g)(1)(DoL); 45 C.F.R.

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Cite This Page — Counsel Stack

Bluebook (online)
919 F. Supp. 2d 622, 2013 WL 228200, 2013 U.S. Dist. LEXIS 8993, Counsel Stack Legal Research, https://law.counselstack.com/opinion/persico-v-sebelius-pawd-2013.