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Sissel v. United States Department of Health and Human Services

United States District Court, District Circuit

June 28, 2013



BERYL A. HOWELL, District Judge.

Pending before the Court is a facial constitutional challenge to 26 U.S.C. § 5000A, which is the requirement to maintain minimum essential insurance coverage contained in the Patient Protection and Affordable Care Act, as amended. The plaintiff, Matthew Sissel, complains that this minimum coverage provision-commonly referred to as the "individual mandate"-is unconstitutional because Congress lacked the power to enact it under the Commerce Clause of the Constitution, and also because it was passed in violation of the Origination Clause of the Constitution. The defendants, who are the primary government agencies and officials charged with overseeing the implementation of the individual mandate, have moved, under Federal Rule of Civil Procedure 12(b)(6), to dismiss the plaintiff's complaint for failure to state a claim on which relief may be granted. In that motion, the defendants contend that the plaintiff's Commerce Clause arguments are foreclosed by the Supreme Court's decision in National Federation of Independent Business v. Sebelius, 132 S.Ct. 2566 (2012). The defendants also argue that the plaintiff's Origination Clause allegations fail to state a claim because the individual mandate is neither a "Bill[] for raising Revenue" subject to the Origination Clause, nor a bill that originated outside the House of Representatives. For the reasons discussed below, the Court grants the defendants' motion.


A. The Affordable Care Act's Minimum Coverage Provision

The Patient Protection and Affordable Care Act (the "Affordable Care Act") began as a bill introduced in the House of Representatives entitled the "Service Members Home Ownership Tax Act of 2009." See H.R. 3590, 111th Cong. (2009). That bill proposed certain amendments to the Internal Revenue Code, including provisions that extended tax benefits to members of the military, the Foreign Service, or the intelligence community who are called to extended duty service, as well as a provision that increased the estimated tax payments owed by corporations with at least $1 billion in assets. See id. §§ 2-3, 6. That bill passed the House of Representatives by a vote of 416 to zero. See 155 Cong. Rec. H11126-27 (daily ed. Oct. 8, 2009). Upon arrival in the Senate, the entire text and title of the bill were stricken except for its enacting clause, and in its place was inserted the text and title of the Affordable Care Act. See 155 Cong. Rec. S11607 (daily ed. Nov. 19, 2009).[1] That version of the bill passed the Senate on December 24, 2009 by a vote of sixty to thirty-nine, see 155 Cong. Rec. S13890-91 (daily ed. Dec. 24, 2009), and later passed the House on March 21, 2010, by a vote of 220 to 211, see 156 Cong. Rec. H1920-2169 (daily ed. Mar. 21, 2010).

On March 23, 2010, the Affordable Care Act was signed into law. See Pub. L. No. 111-148, 124 Stat. 119. One of the provisions in the Affordable Care Act is a requirement that every "applicable individual... ensure that the individual, and any dependent of the individual who is an applicable individual, is covered under minimum essential coverage."[2] See id. § 1501, 124 Stat. at 244 (codified at 26 U.S.C. § 5000A). This same provision provides that, if any "applicable individual" fails to meet the requirement of maintaining "minimum essential" health insurance coverage, that individual is required to pay a "shared responsibility payment" to the federal government.[3] Essentially, this minimum coverage provision-commonly referred to as the "individual mandate"-requires every "applicable individual" to maintain "minimum essential" health insurance coverage, or else make a "shared responsibility payment." The individual mandate takes effect on January 1, 2014. See id. (requiring "minimum essential coverage" for "each month beginning after 2013").

B. Factual and Procedural Background

The plaintiff in the instant case is an artist who lives in Cedar Rapids, Iowa. See Am. Compl. ¶ 5, ECF No. 40. He alleges in his Amended Complaint that 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 claims that "[h]e is able to and does pay for any and all of his medical expenses out of pocket" and "does not have, need, or want health insurance."[4] Id. Despite his alleged aversion to purchasing health insurance, however, the plaintiff also alleges that "[h]e is subject to the [Affordable Care] Act's provisions requiring either the purchase of federally prescribed health insurance or the payment of a tax." Id.

The plaintiff alleges that "he must act now to make financial plans to either buy insurance or make the [shared responsibility] payment." Id. ¶ 23. Specifically, the plaintiff claims that "[i]n anticipation of the costs he must incur to satisfy the [Affordable Care] Act's purchase requirement, he calculates that he will be unable to afford to continue his professional education, " and he "has begun selling his artwork, and will continue to do so, rather than devote his attention full-time to his studies." Id. ¶ 26. Further, the plaintiff alleges that his "ability to attend national and international conferences and workshops relevant to his art profession has been curtailed because he is obliged to reduce expenditures in light of anticipated new health care costs, imposed by the [Affordable Care] Act." Id. ¶ 27.

On July 26, 2010, the plaintiff filed his original Complaint in this Court, which alleged that the Affordable Care Act's individual mandate provision was unconstitutional "because it exceeds Congress's authority under the Commerce Clause." See Compl. ¶ 1, ECF No. 1.[5] The defendants moved to dismiss the plaintiff's Complaint on November 15, 2010. On August 9, 2011, however, the Court stayed proceedings in this case pending the D.C. Circuit's decision in Mead v. Holder, No. 11-5047, which was a case challenging the individual mandate on the same grounds as the plaintiff in the instant case. See Minute Order dated Aug. 9, 2011. The D.C. Circuit issued its decision in that case on November 8, 2011. See Seven-Sky v. Holder, 661 F.3d 1 (D.C. Cir. 2011).

On November 14, 2011, the Supreme Court granted a writ of certiorari in three other cases from the Eleventh Circuit that were, like Seven-Sky and the instant case, facial challenges to the individual mandate. See 132 S.Ct. 603-04 (2011) (mem.). In light of these events, the parties jointly requested that the Court stay these proceedings further, pending the Supreme Court's decision in those three consolidated cases. See Joint Mot. to Stay Proceedings, ECF No. 34. The Court granted the parties' motion on December 1, 2011. See Minute Order dated Dec. 1, 2011. On June 28, 2012, the Supreme Court issued its decision in National Federation of Independent Business v. Sebelius (" NFIB "), 132 S.Ct. 2566 (2012), the substance of which the Court will discuss in more detail below.

On September 11, 2012, the plaintiff moved to amend his Complaint "based on the Supreme Court's new legal framework for assessing the constitutionality of the purchase requirement and the payment" required by the individual mandate. See Pl.'s Mot. for Leave to Amend Compl. at 2, ECF No. 37. In particular, the plaintiff sought to make a "minor amendment" to his Commerce Clause claim "reflecting the fact that, under the Supreme Court's ruling, it is the legal obligation to buy insurance-not the payment-that is unconstitutional." See id. at 1. The plaintiff also sought to add a second claim asserting that the Affordable Care Act's shared responsibility payment violates the Origination Clause of the Constitution. See id. The Court granted the plaintiff's motion to amend on October 11, 2012, and also denied without prejudice, as moot, the defendants' previously filed motion to dismiss. See Minute Order dated Oct. 11, 2012. The defendants then filed a motion to dismiss the plaintiff's Amended Complaint, and in connection with that motion the Court granted leave to the Center for Constitutional Jurisprudence to file an amicus curiae brief in support of the plaintiff's challenge. See Minute Order dated Dec. 4, 2012. Currently pending before the Court is the defendants' Motion to Dismiss Plaintiff's Amended Complaint, ECF No. 43, and, for the reasons discussed below, the Court grants that motion.[6]


To survive a motion to dismiss under Rule 12(b)(6), a plaintiff need only plead "enough facts to state a claim to relief that is plausible on its face" and to "nudge[] [his or her] claims across the line from conceivable to plausible." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007); see also FED. R. CIV. P. 12(b)(6). "[A] complaint [does not] suffice if it tenders naked assertion[s]' devoid of further factual enhancement.'" Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Twombly, 550 U.S. at 557). Instead, the complaint must plead facts that are more than "merely consistent with' a defendant's liability." Id. (quoting Twombly, 550 U.S. at 557). Rather, "the plaintiff [must] plead[] factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Id.; accord Rudder v. Williams, 666 F.3d 790, 794 (D.C. Cir. 2012). The Court "must assume all the allegations in the complaint are true (even if doubtful in ...

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