AETNA HEALTH INC. v. DAVILA

No. 02-1845.

542 U.S. 200 (2004)

AETNA HEALTH INC., FKA AETNA U. S. HEALTHCARE INC., ET AL. v. DAVILA

Supreme Court of United States.

Decided June 21, 2004.


Attorney(s) appearing for the Case

Miguel A. Estrada argued the cause for petitioners in both cases. With him on the briefs in No. 02-1845 were Mark A. Perry, J. Edward Neugebauer, John B. Shely, Kendall M. Gray, and Roy T. Englert, Jr. On the briefs in No. 03-83 were Robert N. Eccles and Jonathan D. Hacker.

James A. Feldman argued the cause for the United States as amicus curiae urging reversal. With him on the brief were Acting Solicitor General Clement, Deputy Solicitor General Kneedler, Howard M. Radzely, Allen H. Feldman, Nathaniel I. Spiller, and Edward D. Sieger.

David Mattax, Assistant Attorney General of Texas, argued the cause for the State of Texas et al. as amici curiae urging affirmance. With him on the brief were Greg Abbott, Attorney General, Barry R. McBee, First Assistant Attorney General, Edward D. Burbach, Deputy Attorney General, R. Ted Cruz, Solicitor General, Rance L. Craft and Kristofer S. Monson, Assistant Solicitors General, and Anabelle Rodríguez, Secretary of Justice of Puerto Rico, and by the Attorneys General for their respective States as follows: Bill Lockyer of California, Richard Blumenthal of Connecticut, M. Jane Brady of Delaware, Lisa Madigan of Illinois, Phill Kline of Kansas, Charles C. Foti, Jr., of Louisiana, J. Joseph Curran, Jr., of Maryland, Mike Hatch of Minnesota, Jeremiah W. "Jay" Nixon of Missouri, Mike McGrath of Montana, Brian Sandoval of Nevada, Patricia A. Madrid of New Mexico, Eliot Spitzer of New York, Jim Petro of Ohio, W. A. Drew Edmondson of Oklahoma, Hardy Myers of Oregon, Mark L. Shurtleff of Utah, William H. Sorrell of Vermont, and Christine O. Gregoire of Washington.

George Parker Young argued the cause for respondents in both cases. With him on the brief was Eric Schnapper.

THOMAS, J., delivered the opinion for a unanimous Court. GINSBURG, J., filed a concurring opinion, in which BREYER, J., joined, p. 222.


JUSTICE THOMAS delivered the opinion of the Court.

In these consolidated cases, two individuals sued their respective health maintenance organizations (HMOs) for alleged failures to exercise ordinary care in the handling of coverage decisions, in violation of a duty imposed by the Texas Health Care Liability Act (THCLA), Tex. Civ. Prac. & Rem. Code Ann. §§ 88.001-88.003 (West 2004 Supp. Pamphlet). We granted...

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