Halbig v. Burwell

Decision Date22 July 2014
Docket NumberNo. 14–5018.,14–5018.
Citation758 F.3d 390
PartiesJacqueline HALBIG, et al., Appellants v. Sylvia Mathews BURWELL, In her Official Capacity as U.S. Secretary of Health and Human Services, et al., Appellees.
CourtU.S. Court of Appeals — District of Columbia Circuit

OPINION TEXT STARTS HERE

Held Invalid

26 C.F.R. § 1.36B–2(a)(1)

Appeal from the United States District Court for the District of Columbia (No. 1:13–cv–00623).

Michael A. Carvin argued the cause for appellants. With him on the briefs were Yaakov M. Roth and Jonathan Berry.

Rebecca A. Beynon, E. Scott Pruitt, Attorney General, Office of the Attorney General for the State of Oklahoma, Patrick R. Wyrick, Solicitor General, Luther Strange, Attorney General, Office of the Attorney General for the State of Alabama, Sam Olens, Attorney General, Office of the Attorney General for the State of Georgia, Patrick Morrisey, Attorney General, Office of the Attorney General for the State of West Virginia, Jon Bruning, Attorney General, Office of the Attorney General for the State of Nebraska, and Alan Wilson, Attorney General, Office of the Attorney General for the State of South Carolina were on the brief for amici curiae Consumer's Research, et al.

C. Boyden Gray, Adam J. White, and Adam R.F. Gustafson were on the brief for amicus curiae The Galen Institute in support of appellants.

Charles J. Cooper, David H. Thompson, Howard C. Nielson, and Michael E. Roman were on the brief for amici curiae Senator John Cornyn, et al. in support of appellants.

John R. Woodrum was on the brief for amicus curiae National Federation of Independent Business Legal Center in support of appellants.

Bert W. Rein, William S. Consovoy, John M. Connolly, and Ilya Shapiro were on the brief for amici curiae Pacific Research Institute, et al. in support of appellants.

Derek Schmidt, Attorney General, Office of the Attorney General for the State of Kansas, Jeffrey A. Chanay, Deputy Attorney General, Stephen R. McAllister, Solicitor General, Bryan C. Clark, Assistant Solicitor General, Bill Schuette, Attorney General, Office of the Attorney General for the State of Michigan, and Jon Bruning, Attorney General, Office of the Attorney General for the State of Nebraska, were on the brief for amici curiae States of Kansas, et al. in support of appellants.

Andrew M. Grossman was on the brief for amici curiae Jonathan Adler, et al. in support of appellants.

Stuart F. Delery, Assistant Attorney General, U.S. Department of Justice, argued the cause for appellees. With him on the brief were Ronald C. Machen, Jr., U.S. Attorney, Beth S. Brinkmann, Deputy Assistant Attorney General, and Mark B. Stern and Alisa B. Klein, Attorneys.

Martha Jane Perkins, Kelly Bagby, Iris Y. Gonzalez, and Michael Schuster were on the brief for amici curiae AARP and National Health Law Program in support of appellees.

Mary P. Rouvelas was on the brief for amici curiae The American Cancer Society, et al. in support of appellees.

H. Guy Collier and Ankur J. Goel were on the brief for amici curiae Public Health Deans, Chairs, and Faculty in support of appellees.

Elizabeth B. Wydra and Simon Lazarus were on the brief for amici curiae Members of Congress and State Legislatures in support of appellees.

Dominic F. Perella, Sean Marotta, and Melinda Reid Hatton were on the brief for amicus curiae The American Hospital Association in support of appellees.

Andrew J. Pincus and Brian D. Netter were on the brief for amicus curiae America's Health Insurance Plans in support of appellees.

Matthew S. Hellman and Matthew E. Price were on the brief for amici curiae Economic Scholars in support of appellees.

Robert Weiner and Murad Hussain were on the brief for amicus curiae Families USA in support of appellees.

Before: GRIFFITH, Circuit Judge, and EDWARDS and RANDOLPH, Senior Circuit Judges.

Opinion for the Court filed by Circuit Judge GRIFFITH.

Concurring opinion filed by Senior Circuit Judge RANDOLPH.

Dissenting opinion filed by Senior Circuit Judge EDWARDS.

GRIFFITH, Circuit Judge:

Section 36B of the Internal Revenue Code, enacted as part of the Patient Protection and Affordable Care Act (ACA or the Act), makes tax credits available as a form of subsidy to individuals who purchase health insurance through marketplaces—known as “American Health Benefit Exchanges,” or “Exchanges” for short—that are “established by the State under section 1311 of the Act. 26 U.S.C. § 36B(c)(2)(A)(i). On its face, this provision authorizes tax credits for insurance purchased on an Exchange established by one of the fifty states or the District of Columbia. See42 U.S.C. § 18024(d). But the Internal Revenue Service has interpreted section 36B broadly to authorize the subsidy also for insurance purchased on an Exchange established by the federal government under section 1321 of the Act. See26 C.F.R. § 1.36B–2(a)( l ) (hereinafter “IRS Rule”).

Appellants are a group of individuals and employers residing in states that did not establish Exchanges. For reasons we explain more fully below, the IRS's interpretation of section 36B makes them subject to certain penalties under the ACA that they would rather not face. Believing that the IRS's interpretation is inconsistent with section 36B, appellants challenge the regulation under the Administrative Procedure Act (APA), alleging that it is not “in accordance with law.” 5 U.S.C. § 706(2)(A).

On cross-motions for summary judgment, the district court rejected that challenge, granting the government's motion and denying appellants'. See Halbig v. Sebelius, No. 13 Civ. 623(PLF), ––– F.Supp.3d ––––, 2014 WL 129023 (D.D.C. Jan. 15, 2014). After resolving several threshold issues related to its jurisdiction, the district court held that the ACA's text, structure, purpose, and legislative history make “clear that Congress intended to make premium tax credits available on both state-run and federally-facilitated Exchanges.” Id. at ––––, 2014 WL 129023 at *18. Furthermore, the court held that even if the ACA were ambiguous, the IRS's regulation would represent a permissible construction entitled to deference under Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837, 104 S.Ct. 2778, 81 L.Ed.2d 694 (1984).

Appellants timely appealed the district court's orders, and we have jurisdiction under 28 U.S.C. § 1291. Our review of the orders is de novo, and [o]n an independent review of the record, we will uphold an agency action unless we find it to be ‘arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law.’ Holland v. Nat'l Mining Ass'n, 309 F.3d 808, 814 (D.C.Cir.2002) (quoting 5 U.S.C. § 706(2)(A)). Because we conclude that the ACA unambiguously restricts the section 36B subsidy to insurance purchased on Exchanges “established by the State,” we reverse the district court and vacate the IRS's regulation.

I

Congress enacted the Patient Protection and Affordable Care Act in 2010 “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 (NFIB), ––– U.S. ––––, 132 S.Ct. 2566, 2580, 183 L.Ed.2d 450 (2012). The ACA pursues these goals through a complex network of interconnected policies focused primarily on helping individuals who do not receive coverage through an employer or government program to purchase affordable insurance directly. Central to this effort are the Exchanges. 42 U.S.C. § 18031(b)(1). Exchanges are “governmental agenc[ies] or nonprofit entit[ies] that serve as both gatekeepers and gateways to health insurance coverage. See id. § 18031(d)(1). Among their many functions as gatekeepers, Exchanges determine which health plans satisfy federal and state standards, and they operate websites that allow individuals and employers to enroll in those that do. See id. § 18031(b)(1), (d)( l )-(d)(4). Section 1311 of the ACA delegates primary responsibility for establishing Exchanges to individual states. See id. § 18031(b)(1) (providing that [e]ach State shall, not later than January 1, 2014, establish an American Health Benefit Exchange (referred to in this title as an ‘Exchange’) for the State). However, because Congress cannot require states to implement federal laws, see Printz v. United States, 521 U.S. 898, 904–05, 935, 117 S.Ct. 2365, 138 L.Ed.2d 914 (1997), if a state refuses or is unable to set up an Exchange, section 1321 provides that the federal government, through the Secretary of Health and Human Services (HHS), “shall ... establish and operate such Exchange within the State.” 42 U.S.C. § 18041(c)(1). As of today, only fourteen states and the District of Columbia have established Exchanges. The federal government has established Exchanges in the remaining thirty-six states, in some cases with state assistance but in most cases not. SeeRichard Cauchi, State Actions To Address Health Insurance Exchanges,Nat'l Conference of State Legislatures (May 9, 2014), http:// www. ncsl. org/ research/ health/ state- actions- to- implement- the- health- benefit. aspx.

Under section 36B, Exchanges also serve as the gateway to the refundable tax credits through which the ACA subsidizes health insurance. See26 U.S.C. § 36B(a). Generally speaking, section 36B authorizes credits for “applicable taxpayer[s],” id., defined as those with household incomes between 100 and 400 percent of the federal poverty line, id. § 36B(c)(1)(A). But section 36B's formula for calculating the credit works further limits on who may receive the subsidy. According to that formula, the credit is to equal the sum of the “premium assistance amounts” for each “coverage month.” Id. § 36B(b)( l ). The “premium assistance amount” is based on the cost of a “qualified health plan ... enrolled in through an Exchange established by the State under [section] 1311 of the [ACA].” Id. § 36B(b)(2); see also42 U.S.C. §§ 18021(a)(1), 18031(c)(1) (establishing requirements for “qualified health plans”). Likewise, a “coverage month” is a...

To continue reading

Request your trial
19 cases
  • Murray Energy Corp. v. McCarthy, Civil Action No. 5:14-CV-39
    • United States
    • U.S. District Court — Northern District of West Virginia
    • October 17, 2016
    ...coal, but EPA does not need to kill a company to injure it. "[E]ven an identifiable trifle of harm may establish standing. Halbig v. Burwell, 758 F.3d 390, 396 (2014) (internal quotations omitted). Plaintiffs also addressed this very point in their depositions, none of which are cited by EP......
  • King v. Burwell, 14–114.
    • United States
    • U.S. Supreme Court
    • June 25, 2015
    ...the IRS Rule in a different case, holding that the Act "unambiguously restricts" the tax credits to State Exchanges. Halbig v. Burwell, 758 F.3d 390, 394 (2014). We granted certiorari in the present case. 574 U.S. ––––, 135 S.Ct. 475, 190 L.Ed.2d 355 (2014).IIThe Affordable Care Act address......
  • Am. Council of Life Insurers v. Dist. of Columbia Health Benefit Exch. Auth.
    • United States
    • U.S. District Court — District of Columbia
    • November 13, 2014
    ...held that the ACA does not allow federal tax credit subsidies for insurance purchased on Federal Exchanges. See Halbig v. Burwell, 758 F.3d 390, 399 (D.C.Cir.2014)reh'g en banc granted, judgment vacated, No. 14–5018, 2014 WL 4627181 (D.C.Cir. Sept. 4, 2014). This opinion has been vacated pe......
  • King v. Burwell
    • United States
    • U.S. Supreme Court
    • June 25, 2015
    ...the IRS Rule in a different case, holding that the Act "unambiguously restricts" the tax credits to State Exchanges. Halbig v. Burwell, 758 F.3d 390, 394 (2014). We granted certiorari in the present case. 574 U.S. ––––, 135 S.Ct. 475, 190 L.Ed.2d 355 (2014).IIThe Affordable Care Act address......
  • Request a trial to view additional results
2 firm's commentaries
2 books & journal articles
  • THE CONGRESSIONAL BUREAUCRACY.
    • United States
    • May 1, 2020
    ...the OLRC--but consider those made by Congress."). (652) For examples of courts relying on CBO calculation, see, e.g., Halbig v. Burwell, 758 F.3d 390, 407-08 (D.C. Cir. 2014) (citing the CBO analysis as inconclusive evidence of congressional intent); King v. Burwell, 759 F.3d 358, 374 (4th ......
  • Deference and Fiction: Reforming Chevron's Legal Fictions After King v. Burwell
    • United States
    • University of Nebraska - Lincoln Nebraska Law Review No. 95, 2021
    • Invalid date
    ...68. King v. Sebelius, 997 F. Supp. 2d 415 (E.D. Va. 2014). 69. King v. Burwell, 759 F.3d 358, 363 (4th Cir. 2014). 70. Halbig v. Burwell, 758 F.3d 390 (D.C. Cir. 2014); see also Oklahoma ex rel. Pruitt v. Burwell, 51 F. Supp. 3d 1080 (E.D. Okla. 2014) (No. 6:11-CV-00030), 2014 WL 4854543 (a......

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT