City of Columbus v. Trump

Citation453 F.Supp.3d 770
Decision Date10 April 2020
Docket NumberCivil Action No. DKC 18-2364
Parties CITY OF COLUMBUS, et al. v. Donald J. TRUMP, in his official capacity as President of the United States of America, et al.
CourtU.S. District Court — District of Maryland

Adam Grogg, Pro Hac Vice, Javier M. Guzman, Pro Hac Vice, John T. Lewis, III, Pro Hac Vice, Democracy Forward Foundation, Sara Kropf, Law Office of Sara Kropf PLLC, Washington, DC, Charles Campisano, Pro Hac Vice, Jennifer Shea, Pro Hac Vice, Lara Baker Morrish, Pro Hac Vice, Zach Klein, Pro Hac Vice, Columbus City Attorney's Office, Columbus, OH, for City of Columbus.

Suzanne Sangree, Andre M. Davis, Elizabeth Ryan Martinez, Jane Hannah Lewis, City of Baltimore Law Department, Baltimore, MD, Adam Grogg, Pro Hac Vice, Javier M. Guzman, Pro Hac Vice, John T. Lewis, III, Pro Hac Vice, Democracy Forward Foundation, Sara Kropf, Law Office of Sara Kropf PLLC, Washington, DC, for Mayor and City Council of Baltimore.

Adam Grogg, Pro Hac Vice, Javier M. Guzman, Pro Hac Vice, John T. Lewis, III, Pro Hac Vice, Democracy Forward Foundation, Sara Kropf, Law Office of Sara Kropf PLLC, Washington, DC, for City of Cincinnati, City of Chicago, Stephen Vondra, Bonnie Morgan.

Adam Grogg, Democracy Forward Foundation, Washington, DC, for City of Philadelphia.

City of Philadelphia, pro se.

Kathryn L. Wyer, Tamra Tyree Moore, US Department of Justice, Washington, DC, for Alex M. Azar, II, United States Department of Health and Human Services, Seema Verma, Centers for Medicare and Medicaid Services.

MEMORANDUM OPINION

DEBORAH K. CHASANOW, United States District Judge Presently pending and ready for resolution in this action for declaratory judgment and injunctive relief is the motion to dismiss the amended complaint filed by Defendants Donald J. Trump, Alex M. Azar, II, the United States Department of Health and Human Services, Seema Verma, and the Centers for Medicare and Medicaid Services. (ECF No. 52). The issues have been fully briefed, and the court now rules, no hearing being deemed necessary. Local Rule 105.6. For the following reasons, the motion to dismiss will be denied in part and granted in part.

I. Factual Background1

Plaintiffs the City of Columbus, Ohio, the Mayor and City Council of Baltimore, Maryland, the City of Cincinnati, Ohio, the City of Chicago, Illinois, and the City of Philadelphia, Pennsylvania (collectively, the "City Plaintiffs") and Stephen Vondra and Bonnie Morgan (collectively, the "Individual Plaintiffs") filed suit against Defendants Donald J. Trump, in his official capacity as President of the United States of America, the United States Department of Health and Human Services ("HHS"), Alex M. Azar, II, in his official capacity as Secretary of HHS, the Centers for Medicare and Medicaid Services ("CMS"), and Seema Verma, in her official capacity as Administrator of CMS, (collectively, "Defendants"). Plaintiffs assert two claims: violation of the Administrative Procedure Act ("APA"), 5 U.S.C. § 706 (Count I) and violation of the Take Care Clause, U.S. Const. art. II, § 3 (Count II).

Central to Plaintiffs’ amended complaint is the Patient Protection and Affordable Care Act (the "ACA," the "Act," or the "Affordable Care Act"). Plaintiffs allege that after "fail[ing] to persuade Congress to repeal the Affordable Care Act, President Trump and his Administration are waging a relentless campaign to sabotage and, ultimately, to nullify the law."2 (ECF No. 44, ¶ 1). Plaintiffs allege that Defendants’ strategy is "[to shift deceptively] the blame from their own actions to the Act itself[ ]" and that Defendants’ objective is "to pressure Congress to repeal the Act or, if that fails, to achieve de facto repeal through executive action alone." (Id. ). Plaintiffs allege that Defendants’ actions force the City Plaintiffs "to spend more on uncompensated care for their residents[ ]" and the Individual Plaintiffs "to pay more for the quality health insurance coverage they need[.]" (Id. , ¶ 4).

A. The ACA

In 2010, Congress passed and President Obama signed into law the Affordable Care Act "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, 132 S.Ct. 2566, 183 L.Ed.2d 450 (2012) (" NFIB "). The ACA "adopts a series of interlocking reforms designed to expand coverage in the individual health insurance market." King v. Burwell , 576 U.S. 473, 135 S.Ct. 2480, 2485, 192 L.Ed.2d 483 (2015). "Individual health insurance is insurance that individuals purchase themselves, in contrast to, for example, joining employer-sponsored group health plans." (ECF No. 44, ¶ 32). "Prior to the enactment of the ACA, individual health insurance markets were dysfunctional." (Id. ). The ACA "aims to achieve systemic improvements in the individual health insurance market by means of certain key reforms[.]" (Id. , ¶ 33). Plaintiffs’ amended complaint highlights four such reforms. (Id. , ¶¶ 33-34).

First, "Congress addressed the problem of those who cannot obtain insurance coverage because of preexisting conditions or other health issues ... through the Act's ‘guaranteed-issue’ and ‘community rating’ provisions." NFIB , 567 U.S. at 547-48, 132 S.Ct. 2566. "These provisions together prohibit insurance companies from denying coverage to those with such conditions or charging unhealthy individuals higher premiums than healthy individuals." Id. at 548, 132 S.Ct. 2566 (citing 42 U.S.C. §§ 300gg, 300gg-1, 300gg-3, 300gg-4 ).

Second, recognizing that "[t]he guaranteed-issue and community-rating reforms do not ... address the issue of healthy individuals who choose not to purchase insurance to cover potential health care needs[,]" id. , Congress "required individuals to maintain health insurance coverage [ (the individual mandate) ] or make a shared responsibility payment to the Internal Revenue Service[,]" (ECF No. 44, ¶ 34).

Third, the ACA requires ACA-compliant plans to cover essential health benefits and limits "so-called ‘cost-sharing’ – for example, deductibles and copayments – for essential health benefits coverage[.]" (ECF No. 44, ¶ 33b). The ACA also "prohibits plans from imposing annual or lifetime limits" on essential health benefits coverage. (Id. ).

Fourth, the ACA "seeks to make insurance more affordable by giving refundable tax credits to individuals with household incomes between 100 percent and 400 percent of the federal poverty line [ ("FPL") ]." (ECF No. 44, ¶ 33c (quoting King , 135 S.Ct. at 2487 )). Qualified individuals receive income-related, premium-based tax credits (advance premium tax credits or "APTCs").3 (Id. ). The ACA "also requires health insurance issuers to reduce certain individuals’ cost-sharing expenditures and directs HHS to reimburse issuers for such cost-sharing reductions (‘CSRs’)." (Id. ).

"To facilitate individuals’ ability to learn about and enroll in the health insurance options that are available to them, the ACA ‘requires the creation of an "Exchange" in each State where people can shop for insurance, usually online.’ " (ECF No. 44, ¶ 35 (quoting King , 135 S.Ct. at 2487 )). "An exchange may be established by the state in which it operates or, in states that elect not to establish exchanges, by the federal government."4 (Id. , ¶ 38).

The exchanges serve as marketplaces, allowing people not eligible for Medicare or Medicaid to compare and purchase ACA-compliant insurance plans, known as "qualified health plans" or "QHPs" under the Act. (ECF No. 44, ¶ 35). Individuals may enroll during an annual open enrollment period or, after a qualifying life event, during a special enrollment period. The exchanges "help consumers make smart health insurance choices by running call centers and providing in-person assistance." (Id. , ¶ 37). Pertinently, "the ACA requires that exchanges award grants to healthcare ‘Navigators’ to ‘carry out ... duties’ that are specified by statute and in HHS implementing regulations[.]" (Id. (citations omitted)).

"The ACA requires that exchanges offer only quality health insurance[.]" (ECF No. 44, ¶ 39). Such coverage "improve[s] access to care and overall health[ ]" and "reduce[s] financial burdens for both individuals and institutions that cover the costs of uncompensated care." (Id. ). Plaintiffs allege that increasing enrollment in quality health insurance coverage is both the ACA's immediate goal and the key to the ACA's long-term success. Enrollment "must be high enough to reduce random fluctuations in claims from year to year[.]" (Id. ). Enough healthy individuals must enroll to spread the costs of less-healthy individuals. (Id. ). To promote increased enrollment, health care costs must be limited. (Id. , ¶ 40). Plaintiffs allege that before Defendants’ actions, "the ACA's reforms successfully met Congress's goal of enabling more individuals – specifically, 20 million more individuals – to enroll in health insurance coverage." (Id. , ¶¶ 41-43).

B. Defendants’ Challenged Actions

Plaintiffs dedicate 12 pages of the amended complaint to cataloging the many statements made by the President and members of his Administration that they allege express contempt for the Act. (ECF No. 44, ¶¶ 44-48). According to Plaintiffs, these statements evince "the Administration's intent to repeal the ACA, with or without Congress." (Id. , at 22).

Plaintiffs also challenge Defendants’ actions. "At issue here are a final rule and a long list ... of other executive actions, all undertaken by the Trump Administration to undermine the ACA." (ECF No. 44, ¶ 9). "The final rule is [CMS's] Notice of Benefit and Payment Parameters for 2019, 83 Fed. Reg. 16,930 (April 17, 2018), referenced here as the 2019 Rule [because] it governs many aspects of ACA insurance markets starting in the 2019 plan year." (Id. , ¶ 10). The challenged executive actions include two executive orders, Executive Order No. 13,765, titled " Minimizing the Economic Burden of the Patient Protection and Affordable Care Act...

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    • United States
    • U.S. District Court — District of Maryland
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    ...individuals purchase themselves, in contrast to, for example, joining employer-sponsored group health plans." City of Columbus v. Trump , 453 F. Supp. 3d 770, 778 (D. Md. 2020) (citing ECF No. 44, ¶ 32). Individual market health plans are referred to as qualified health plans ("QHPs")."Prio......
  • Las Ams. Immigrant Advocacy Ctr. v. Biden
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  • Macedo v. Elrich
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    ... ... Procedure 12(b)(6) tests the sufficiency of the complaint ... Presley v. City of Charlottesville , 464 F.3d 480, ... 483 (4th Cir. 2006) (citation and internal quotation ... entity.”); see, e.g. , City of Columbus v ... Trump , 453 F.Supp.3d 770 (D. Md. 2020); Trump v ... Int'l Refugee Assistance ... ...
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2 books & journal articles
  • ADMINISTRATIVE SABOTAGE.
    • United States
    • Michigan Law Review Vol. 120 No. 5, March 2022
    • March 1, 2022
    ...Care Clause." Texas, 809 F.3d at 146 n.3. (119.) Complaint for Declaratory & Injunctive Relief at 1, City of Columbus v. Trump, 453 F. Supp. 3d 770 (D. Md. 2020) (No. (120.) Id. (121.) See id. at 2 (detailing various agency actions that had "promoted] insurance that does not comply with......
  • Unrules.
    • United States
    • Stanford Law Review Vol. 73 No. 4, April 2021
    • April 1, 2021
    ...6, 2018), https://perma.cc/53AX-ZCHF. (139.) Amended Complaint for Declaratory and Injunctive Relief at 3, City of Columbus v. Trump, 453 F. Supp. 3d 770 (D. Md. 2020) (No. 18-cv-2364), 2019 WL 2118179, ECF No. (140.) Nicholas Bagley & Abbe R. Gluck, Opinion, Trump's Sabotage of Obamaca......

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