Sissel v. U.S. Dep't of Health & Human Servs., No. 13–5202.

CourtUnited States Courts of Appeals. United States Court of Appeals (District of Columbia)
Writing for the CourtROGERS
Citation760 F.3d 1
PartiesMatt SISSEL, Appellant v. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, et al., Appellees.
Decision Date29 July 2014
Docket NumberNo. 13–5202.

760 F.3d 1

Matt SISSEL, Appellant
v.
UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, et al., Appellees.

No. 13–5202.

United States Court of Appeals,
District of Columbia Circuit.

Argued May 8, 2014.
Decided July 29, 2014.


[760 F.3d 2]


Appeal from the United States District Court for the District of Columbia (No. 1:10–cv–01263).

Timothy M. Sandefur argued the cause for appellant.
With him on the briefs were Paul J. Beard II and Daniel A. Himebaugh. Theodore Hadzi–Antich entered an appearance.

John C. Eastman and Anthony T. Caso were on the brief for amicus curiae Center for Constitutional Jurisprudence in support of appellant.


Lawrence J. Joseph was on the brief for amicus curiae Association of American Physicians and Surgeons in support of appellant.

Joseph E. Schmitz and Paul D. Kamenar were on the brief for amici curiae U.S. Representatives Trent Franks, et al. in support of appellant.

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

Before: ROGERS, PILLARD and WILKINS, Circuit Judges.

Opinion for the Court filed by Circuit Judge ROGERS.

ROGERS, Circuit Judge:

Section 5000A of the Patient Protection and Affordable Care Act, 26 U.S.C. § 5000A, mandates that as of January 2014, non-exempt individuals maintain minimum health care coverage or, with limited exceptions, pay a penalty. Matt Sissel, who is an artist and small-business

[760 F.3d 3]

owner who serves from time to time on active duty with the National Guard, appeals the dismissal of his complaint alleging that the mandate violates the Commerce Clause, U.S. Const. art. I, § 8, cl. 3, and the Origination Clause, U.S. Const. art. I, § 7, cl. 1. We affirm, because his contention that the mandate obligating him to buy government-approved health insurance violates the Commerce Clause fails under the Supreme Court's interpretation of the mandate in National Federation of Independent Business v. Sebelius, ––– U.S. ––––, 132 S.Ct. 2566, 2598, 183 L.Ed.2d 450 (2012) (“ NFIB ”), and his contention that the mandate's shared responsibility payment was enacted in violation of the Origination Clause fails under Supreme Court precedent interpreting that Clause.

I.
A.

Section 5000A of the Affordable Care Act imposes a “[r]equirement to maintain minimum essential [health insurance] coverage.” 26 U.S.C. § 5000A. Subsection (a) provides that “[a]n applicable individual”—that is, an individual subject to the requirement—“shall for each month beginning after 2013 ensure that the individual, and any dependent of the individual who is an applicable individual, is covered under minimum essential coverage for such month.” Id. § 5000A(a). Subsection (b) provides that if an applicable individual “fails to meet the requirement of subsection (a),” there shall be “imposed on the taxpayer a penalty,” id. § 5000A(b)(1), denominated the “[s]hared responsibility payment,” id., which “shall be included with a taxpayer's [federal income tax] return,” id. § 5000A(b)(2). These requirements are subject to several exceptions.

Subsection (d) limits who is an “applicable individual” subject to the coverage requirement. See id. § 5000A(d)(2)-(4). The “[r]eligious conscience exemption,” id. § 5000A(d)(2)(A), exempts from the minimum coverage requirement a “member of a recognized religious sect” whose beliefs oppose the acceptance of insurance benefits and an “adherent of established tenets or teachings of such sect.” See also id. § 1402(g)(1) (criteria for religious exemption). Also exempt is a “member of a [qualifying] health care sharing ministry” whose members “share a common set of ethical or religious beliefs and share medical expenses among members in accordance with those beliefs.” Id. § 5000A(d)(2)(B)(i) & (ii)(II). “Individuals not lawfully present” in the United States, id. § 5000A(d)(3), and “[i]ncarcerated individuals,” id. § 5000A(d)(4), are likewise exempt from the insurance purchase requirement.

Subsection (e) enumerates when “[n]o penalty shall be imposed” for failure to obtain required health coverage. Id. § 5000A(e). Exempt are “[i]ndividuals who cannot afford coverage,” that is, individuals whose “required contribution (determined on an annual basis) for coverage for the month exceeds 8 percent of such individual's household income for the taxable year.” Id. § 5000A(e)(1) (emphasis added). The “required contribution” is the cost of obtaining minimum essential coverage, either through an employer-sponsored insurance plan or by purchasing in an insurance exchange “the lowest cost bronze plan available in the individual market ... in which the individual resides.” Id. § 5000A(e)(1)(B). Also exempt are “[t]axpayers with income below [the] filing threshold [for federal income taxes],” id. § 5000A(e)(2), “[m]embers of Indian tribes,” id. § 5000A(e)(3), and individuals experiencing a “short ... gap[ ]” in coverage of less than three months, id. § 5000A(e)(4). Individuals who “have suffered a hardship with respect to the capability to obtain coverage under a qualified

[760 F.3d 4]

health plan,” as determined by the Secretary of Health and Human Services, are also exempt. Id. § 5000A(e)(5).

B.

According to the complaint filed October 11, 2012, Matt Sissel is an “artist who works out of his studio” in Iowa and “also works part-time ... for the National Guard.” First Am. Compl. (“Compl.”) ¶ 5. “He is financially stable, has an annual income that requires him to file federal tax returns, and could afford health insurance if he wanted to obtain such coverage.” Id. He “does not have, need, or want health insurance.” Id. Further, “he is able to and does pay for any and all of his medical expenses out of pocket.” Id. Because “he cannot claim any of the exemptions,” id. ¶ 15, the Affordable Care “Act obligates [him] to purchase, at his own expense and against his will, federally approved health insurance, or pay the ‘shared responsibility payment,’ ” id. Sissel seeks declaratory and injunctive relief against the mandate and the Affordable Care Act in toto.

First, Sissel alleges that the Affordable Care Act's “purchase requirement,” commonly known as the individual mandate, “is not a regulation of commerce, but purports to compel affected Americans, like [himself], to engage in commerce.” Id. ¶ 34. Citing NFIB, 132 S.Ct. at 2600, where Chief Justice Roberts stated that “the Commerce Clause does not authorize such a command,” he alleges that Section 5000A violates the Commerce Clause. See id. Second, he alleges that Section 5000A's “ ‘shared responsibility payment’ is a tax that raises revenue to support Government generally,” id. ¶ 39, and violates the Origination Clause because it “originated in the Senate, not the House,” id. ¶ 40.

The district court dismissed the complaint pursuant to Federal Rule of Civil Procedure 12(b)(6), ruling that Sissel's Commerce Clause claim was premised on a misreading of the NFIB decision, the Origination Clause did not apply because Section 5000A was not a bill for raising revenue, and, in any event, it satisfied the Origination Clause because there was a valid Senate amendment to a bill that originated in the House of Representatives. See Sissel v. U.S. Dep't of Health & Human Servs., 951 F.Supp.2d 159, 166–74 (D.D.C.2013). Sissel appeals, and our review of the dismissal of the complaint is de novo. See English v. Dist. of Columbia, 717 F.3d 968, 971 (D.C.Cir.2013). “To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’ ” Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007)). The court assumes the truth of all well-pleaded factual allegations in the complaint and construes reasonable inferences from those allegations in the plaintiff's favor, see, e.g., Doe v. Rumsfeld, 683 F.3d 390, 391 (D.C.Cir.2012), but is not required to accept the plaintiff's legal conclusions as correct, see id.

II.

As a threshold matter, we must determine whether or not Sissel has standing under Article III of the Constitution in order to assure ourselves that this court has jurisdiction over his appeal. See Lujan v. Defenders of Wildlife, 504 U.S. 555, 559–60, 112 S.Ct. 2130, 119 L.Ed.2d 351 (1992); U.S. Telecom Ass'n v. FCC, 295 F.3d 1326, 1330 (D.C.Cir.2002). Standing must be shown at each stage of the judicial proceedings. See Hollingsworth v. Perry, ––– U.S. ––––, 133 S.Ct. 2652, 2661, 186 L.Ed.2d 768 (2013). The district court concluded Sissel had standing because he claimed to have had to sell property and

[760 F.3d 5]

curtail his professional activities in order to raise funds to pay for the required health insurance coverage. See Sissel, 951 F.Supp.2d at 164 n. 7. Sissel's complaint, however, does not demonstrate that as of the time of his appeal, he would be subject to the Affordable Care Act's individual mandate and shared responsibility payment. Although he alleged that in January 2008 he left the National Guard where he did have health insurance during his active service, see Compl. ¶ 24, his counsel advised during oral argument before this court that Sissel was currently on active duty with the National Guard. See Oral Arg. Tr. 5:14–17 (May 8, 2014). It also was unclear from the complaint whether the circumstances relating to Sissel's annual income and relied on by the district court had changed. See id. at 7:8–20.

Upon review of the requested supplementation, see Order (May 22, 2014), we hold that Sissel has Article III standing. By signed affidavit, Sissel attests that he does not fall within any of the exemptions under the Affordable Care Act, 26 U.S.C. § 5000A(d)(2)-(4), (e)(3). For example, he avers that he has no...

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123 practice notes
  • Proctor v. Dist. of Columbia, Civil Action No. 13–00985
    • United States
    • United States District Courts. United States District Court (Columbia)
    • November 25, 2014
    ...all factual allegations in the complaint as true, even if doubtful in fact. Twombly , at 555, 127 S.Ct. 1955 ; Sissel v. United States HHS, 760 F.3d 1 (D.C.Cir.2014) (in considering Rule 12(b)(6) motion, the “court assumes the truth of all well-pleaded factual allegations in the complaint a......
  • Hotze v. Burwell, No. 14–20039.
    • United States
    • United States Courts of Appeals. United States Court of Appeals (5th Circuit)
    • April 24, 2015
    ...that, to comply, he must either purchase health insurance or pay the penalty. See, e.g., Sissel v. U.S. Dep't of Health and Human Servs., 760 F.3d 1, 4–5 (D.C.Cir.2014). Furthermore, Dr. Hotze's other standing arguments depend on injuries that are either too “speculative,” see Clapper v. Am......
  • Sec. Indus. & Fin. Markets Ass'n v. U.S. Commodity Futures Trading Comm'n, Civil Action No. 13–1916 PLF
    • United States
    • United States District Courts. United States District Court (Columbia)
    • September 16, 2014
    ...the statements set forth in plaintiffs' members' declarations in support of standing. See Sissel v. U.S. Dep't of Health & Human Servs., 760 F.3d 1, 2014 WL 3714701, at *3 (D.C.Cir. July 29, 2014). And third, at the summary judgment stage, the Court must view the evidence in the light most ......
  • Palmieri v. United States, Civil Action No. 12–1403 JDB
    • United States
    • United States District Courts. United States District Court (Columbia)
    • November 3, 2014
    ...to dismiss, the well-pleaded allegations of plaintiff's complaint will be taken as true. Sissel v. U.S. Dep't of Health and Human Servs., 760 F.3d 1, 4 (D.C.Cir.2014).4 The Court will consider in its analysis of the defendants' motion to dismiss the two DOHA opinions—from November 27, 2012,......
  • Request a trial to view additional results
123 cases
  • Proctor v. Dist. of Columbia, Civil Action No. 13–00985
    • United States
    • United States District Courts. United States District Court (Columbia)
    • November 25, 2014
    ...all factual allegations in the complaint as true, even if doubtful in fact. Twombly , at 555, 127 S.Ct. 1955 ; Sissel v. United States HHS, 760 F.3d 1 (D.C.Cir.2014) (in considering Rule 12(b)(6) motion, the “court assumes the truth of all well-pleaded factual allegations in the complaint a......
  • Hotze v. Burwell, No. 14–20039.
    • United States
    • United States Courts of Appeals. United States Court of Appeals (5th Circuit)
    • April 24, 2015
    ...that, to comply, he must either purchase health insurance or pay the penalty. See, e.g., Sissel v. U.S. Dep't of Health and Human Servs., 760 F.3d 1, 4–5 (D.C.Cir.2014). Furthermore, Dr. Hotze's other standing arguments depend on injuries that are either too “speculative,” see Clapper v. Am......
  • Sec. Indus. & Fin. Markets Ass'n v. U.S. Commodity Futures Trading Comm'n, Civil Action No. 13–1916 PLF
    • United States
    • United States District Courts. United States District Court (Columbia)
    • September 16, 2014
    ...the statements set forth in plaintiffs' members' declarations in support of standing. See Sissel v. U.S. Dep't of Health & Human Servs., 760 F.3d 1, 2014 WL 3714701, at *3 (D.C.Cir. July 29, 2014). And third, at the summary judgment stage, the Court must view the evidence in the light most ......
  • Palmieri v. United States, Civil Action No. 12–1403 JDB
    • United States
    • United States District Courts. United States District Court (Columbia)
    • November 3, 2014
    ...to dismiss, the well-pleaded allegations of plaintiff's complaint will be taken as true. Sissel v. U.S. Dep't of Health and Human Servs., 760 F.3d 1, 4 (D.C.Cir.2014).4 The Court will consider in its analysis of the defendants' motion to dismiss the two DOHA opinions—from November 27, 2012,......
  • Request a trial to view additional results

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