Tovar v. Essentia Health

• Decision Date: 24 May 2017
• Docket Number: No. 16-3186,16-3186
• Citation: 857 F.3d 771
• Parties: Brittany R. TOVAR, Plaintiff–Appellant v. ESSENTIA HEALTH; Innovis Health, LLC, doing business as Essentia Health West; HealthPartners, Inc.; HealthPartners Administrators, Inc., Defendants–Appellees Transgender Legal Defense and Education Fund ; Whitman Walker Health; World Professional Association for Transgender Health, Amici on Behalf of Appellant(s)
• Court: U.S. Court of Appeals — Eighth Circuit

857 F.3d 771

Brittany R. TOVAR, Plaintiff–Appellant

v.ESSENTIA HEALTH; Innovis Health, LLC, doing business as Essentia Health West; HealthPartners, Inc.; HealthPartners Administrators, Inc., Defendants–Appellees

Transgender Legal Defense and Education Fund ; Whitman Walker Health; World Professional Association for Transgender Health, Amici on Behalf of Appellant(s)

No. 16-3186

United States Court of Appeals, Eighth Circuit.

Submitted: March 7, 2017

Filed: May 24, 2017

Counsel who presented argument on behalf of the appellant was Jill Renee Gaulding, of Saint Paul, MN. The following attorneys also appeared on the appellant brief; Lisa C. Stratton, of Saint Paul, MN., Christy L. Hall, of Saint Paul, MN.

Counsel who presented argument on behalf of the appellees HealthPartners, Inc. and HealthPartners Administrators, Inc. was David M. Wilk, of Saint Paul, MN. The following attorney also appeared on the appellee brief of HealthPartners, Inc. and HealthPartners Administrators, Inc.; Stephanie Chandler, of Saint Paul, MN.

Counsel who presented argument on behalf of the appellees Essentia Health and Innovis Health, LLC, doing business as Essentia Health West was Lisa Kay Edison–Smith, of Fargo, ND. The following attorney also appeared on the appellee brief of Essentia Health and Innovis Health, LLC, doing business as Essentia Health West; Vanessa L. Anderson, of Fargo, ND.

The following attorneys appeared on the amicus brief; Jean Marie Boler, of Minneapolis, MN., Ezra Young, of New York, NY., Anna Veit–Carter, of Minneapolis, MN.

Before BENTON, BEAM, and MURPHY, Circuit Judges.

MURPHY, Circuit Judge.

Brittany Tovar was employed by defendant Essentia Health or defendant Innovis Health, LLC, dba Essentia Health West (collectively, Essentia) from 2010 to 2016. One of the benefits of Tovar's employment was enrollment in an employer provided health insurance plan which also covered her teenage son. In 2014 Tovar's son was diagnosed with gender dysphoria

. Tovar sought coverage for medications and surgery for her son, but her requests for coverage were denied on the basis of a categorical exclusion in the insurance plan for "[s]ervices and/or surgery for gender reassignment." Tovar then filed this lawsuit against Essentia and the plan's third party administrator for sex based discrimination in violation of Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000e et seq., the Minnesota Human Rights Act (MHRA), Minn. Stat. § 363A.01 et seq., and the Affordable Care Act (ACA), 42 U.S.C. § 18116. The defendants moved to dismiss Tovar's claims, and the district court granted their motions. Tovar appeals. We affirm in part, reverse in part, and remand for further proceedings.

I.

Brittany Tovar is a nurse practitioner who was employed by Essentia from 2010 to 2016. Tovar's benefits as an employee of Essentia included health insurance provided through the Essentia Health Employee Medical Plan (the plan). The plan corresponded to an insurance policy offered to employers by HealthPartners, Inc. and was administered either by HealthPartners, Inc. or by its subsidiary HealthPartners Administrators, Inc. (HPAI).

In 2014 Tovar's teenage son became a beneficiary of the plan. Later that year Tovar's son was diagnosed with gender dysphoria

, a condition that arises when an individual's gender identity differs from the gender assigned at birth. Health professionals decided that various treatments were necessary to treat her son's condition, including medications and gender reassignment surgery. Tovar sought coverage under the plan, but because the plan at that time categorically excluded coverage of "[s]ervices and/or surgery for gender reassignment," the defendants declined to pay for her son's treatment. The coverage dispute caused Tovar "worry, anger, disappointment, and sleepless nights," made it "more difficult for her to focus on her work," and led her to suffer "a sharp increase in migraines." Tovar also paid herself for at least one of her son's prescribed medications although Essentia "later agreed to provide Tovar with coverage for [that medication] as a one-time exception" to its categorical bar on coverage. Tovar's son was forced to forgo another prescribed medication that the family was unable to pay for and was unable to go forward with gender reassignment surgery

.

Tovar filed this lawsuit in January 2016. Her complaint charged Essentia with sex discrimination in violation of Title VII and the MHRA and charged HealthPartners, Inc. with discrimination in violation of the ACA. The defendants moved to dismiss the complaint. The district court granted the defendants' motions, concluding that Tovar's claims against Essentia failed for lack of statutory standing and that her claim against HealthPartners, Inc.¹ failed for lack of Article III standing. Tovar appeals.

II.

A.

Tovar argues that the district court erred by dismissing her claims against Essentia under Title VII and the MHRA for lack of "statutory standing." The Supreme Court has recently commented that it has observed confusion about the concept of standing and has suggested that the use of that term in conjunction with anything other than the "irreducible constitutional minimum of standing" provided by Article III should be disfavored. See Lexmark Int'l, Inc. v. Static Control Components, Inc. , ––– U.S. ––––, 134 S.Ct. 1377, 1386–87 & n.4, 188 L.Ed.2d 392 (2014) (quoting Lujan v. Defs. of Wildlife , 504 U.S. 555, 560, 112 S.Ct. 2130, 119 L.Ed.2d 351 (1992) ). Although the term "statutory standing" may be subject to some confusion, its purpose is clear: a plaintiff who seeks relief for violation of a statute must "fall [ ] within the class of plaintiffs whom Congress has authorized to sue" under that statute. See id. at 1387. Determining whether this requirement is satisfied is "a straightforward question of statutory interpretation." Id. at 1388. If a court determines that Congress has not provided a statutory cause of action in a particular case, it may be subject to dismissal under Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim. See, e.g. , Leyse v. Bank of Am. Nat'l Ass'n , 804 F.3d 316, 320 (3d Cir. 2015) ; Minden Pictures, Inc. v. John Wiley & Sons, Inc. , 795 F.3d 997, 1001 (9th Cir. 2015).

We review a district court's dismissal of a complaint under Rule 12(b)(6)"de novo, accepting as true the factual allegations contained in the complaint and granting [the plaintiff] the benefit of all reasonable inferences that can be drawn from those allegations." Gomez v. Wells Fargo Bank, N.A. , 676 F.3d 655, 660 (8th Cir. 2012). To avoid dismissal, "a complaint must contain sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face."Id. (quoting Ashcroft v. Iqbal , 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009) ). The requirement of facial plausibility is satisfied "when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Iqbal , 556 U.S. at 678, 129 S.Ct. 1937.

In this case the district court concluded that Tovar's complaint failed to state a claim for relief under Title VII and the MHRA because she does not fall within the class of plaintiffs these statutes protect. Specifically, Title VII prohibits an employer from discriminating "against any individual with respect to his compensation, terms, conditions, or privileges of employment, because of such individual's ... sex." 42 U.S.C. § 2000e–2(a) (emphasis added). The court concluded that because Tovar had not alleged her employer discriminated against her on the basis of her own sex, but rather alleged discrimination against her on the basis of her son's sex, her complaint failed to state a claim for relief under Title VII. Similarly, the MHRA makes it illegal for an employer to discriminate against someone because of her sex with respect to her terms, conditions, or privileges of employment. Minn. Stat. § 363A.08, subd. 2(3). The MHRA further states that "[a]ny person aggrieved by a violation of this chapter may bring a civil action." Id. § 363A.28, subd. 1. The district court concluded that Tovar's son was the real "person aggrieved" by Essentia's actions, not Tovar. The court therefore concluded that Tovar's complaint failed to state a claim under the MHRA. Tovar contends that these determinations were in error.

We note two preliminary points before reaching the merits of Tovar's argument. First, the district court applied the same analysis to Tovar's claims under both Title VII and the MHRA. The parties have done the same in their briefing and arguments on appeal. The Minnesota Supreme Court has made clear that it "relie[s] on federal law interpreting Title VII in [its] interpretation of the MHRA," Rasmussen v. Two Harbors Fish Co. , 832 N.W.2d 790, 796 (Minn. 2013), and Tovar has not argued that the statutes are substantively different with respect to the issues presented in this case, see United States v. Wearing , 837 F.3d 905, 910 n.6 (8th Cir. 2016) (per curiam) (arguments not sufficiently developed in opening brief are deemed waived). We will therefore also assume that the protections of Title VII and the MHRA are the same for purposes of this case. See Liles v. C.S. McCrossan, Inc. , 851 F.3d 810, 818 (8th Cir. 2017). Second, because the district court concluded that Tovar is not within the class of plaintiffs for whom Title VII and the MHRA create causes of action, we assume for purposes of this appeal that the prohibition on sex based discrimination under Title VII and the MHRA encompasses protection for transgender individuals. See Hunter v. United Parcel Serv., Inc. , 697 F.3d 697, 702 (8th Cir. 2012).

Beyond those initial points, we are left with a narrow question: does Tovar's complaint on her own behalf² about her employer's refusal to cover treatment for her son fall within the protections of Title VII and the MHRA? We conclude that it does not.

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