TEXAS v. U.S.

No. 19-10011.

945 F.3d 355 (2019)

State of TEXAS; State of Alabama; State of Arizona; State of Florida; State of Georgia; State of Indiana; State of Kansas; State of Louisiana; State of Mississippi, by and through Governor Phil Bryant; State of Missouri; State of Nebraska; State of North Dakota; State of South Carolina; State of South Dakota; State of Tennessee; State of Utah; State of West Virginia; State of Arkansas; Neill Hurley; John Nantz, Plaintiffs-Appellees, v. UNITED STATES of America; United States Department of Health; Human Services; Alex Azar, II, Secretary, U.S. Department of Health and Human Services; United States Department of Internal Revenue; Charles P. Rettig, in his Official Capacity as Commissioner of Internal Revenue, Defendants-Appellants, State of California; State of Connecticut; District of Columbia; State of Delaware; State of Hawaii; State of Illinois; State of Kentucky; State of Massachusetts; State of New Jersey; State of New York; State of North Carolina; State of Oregon; State of Rhode Island; State of Vermont; State of Virginia; State of Washington; State of Minnesota, Intervenor-Defendants-Appellants.

United States Court of Appeals, Fifth Circuit.

REVISED December 20, 2019.


Attorney(s) appearing for the Case

Kyle Douglas Hawkins , Lanora Christine Pettit, Office of the Attorney General, Office of the Solicitor General, Austin, TX, Matthew Hamilton Frederick , Deputy Solicitor General, Office of the Solicitor General for the State of Texas, Austin, TX, David J. Hacker , Office of the Attorney General of Texas Environmental Protection Division, Austin, TX, Darren Lee McCarty, Esq. , Office of the Attorney General for the State of Texas, Austin, TX, for Plaintiffs-Appellees State of Texas, State of Alabama, State of Arizona, State of Florida, State of Georgia, State of Indiana, State of Kansas, State of Louisiana, State of Mississippi, by and through Governor Phil Bryant, State of Nebraska, State of North Dakota, State of South Carolina, State of South Dakota, State of Tennessee, State of Utah, State of West Virginia, State of Arkansas.

Robert E. Henneke , Munera Al-Fuhaid , Texas Public Policy Foundation, Austin, TX, for Plaintiffs-Appellees Neill Hurley, John Nantz.

Samuel Siegel , Sacramento, CA, Kathleen Boergers , Office of the Attorney General for the State of California, Oakland, CA, Nimrod Elias , Office of the Attorney General for the State of California, San Francisco, CA, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, for Intervenor Defendant-Appellant State of California.

Samuel Siegel , Sacramento, CA, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, Joseph Rubin , Office of the Attorney General for the State of Connecticut, Hartford, CT, for Intervenor Defendant-Appellant State of Connecticut.

Samuel Siegel , Sacramento, CA, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, Caroline Van Zile, Esq. , Office of the Attorney General for the District of Columbia, Washington, DC, for Intervenor Defendant-Appellant District of Columbia.

Samuel Siegel , Sacramento, CA, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, Jessica Willey , Delaware Department of Justice, Wilmington, DE, for Intervenor Defendant-Appellant State of Delaware.

Samuel Siegel , Sacramento, CA, Robert Tadao Nakatsuji , Office of the Attorney General for the State of Hawaii, Honolulu, HI, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, for Intervenor Defendant-Appellant State of Hawaii.

Samuel Siegel , Sacramento, CA, Bridget DiBattista , Illinois Attorney General's Office Civil Appeals Division, Chicago, IL, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, for Intervenor Defendant-Appellant State of Illinois.

Samuel Siegel , Sacramento, CA, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, for Intervenor Defendants-Appellants State of Kentucky, State of New York, State of North Carolina, State of Oregon.

Samuel Siegel , Sacramento, CA, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, Stephen B. Vogel , Office of Massachusetts Attorney General, Boston, MA, for Intervenor Defendant-Appellant State of Massachusetts.

Matthew Joseph Berns , Marie Soueid , Office of the Attorney General for the State of New Jersey, Trenton, NJ, Samuel Siegel, Sacramento, CA, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, for Intervenor Defendant-Appellant State of New Jersey.

Samuel Siegel , Sacramento, CA, Maria Rose Lenz , RI Department of Attorney General Civil, Providence, RI, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, for Intervenor Defendant-Appellant State of Rhode Island.

Samuel Siegel , Sacramento, CA, Benjamin Battles , Office of the Attorney General for the State of Vermont, Montpelier, VT, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, for Intervenor Defendant-Appellant State of Vermont.

Matthew Robert McGuire , Deputy Solicitor, Hunton Andrews Kurth, L.L.P., Richmond, VA, Samuel Siegel , Sacramento, CA, Michelle Shane Kallen , Deputy Solicitor General, Office of the Attorney General Solicitor General Division, Richmond, VA, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, for Intervenor Defendant-Appellant State of Virginia.

Samuel Siegel , Sacramento, CA, Neli N. Palma , Deputy Assistant Attorney General, Office of the Attorney General for the State of California, Sacramento, CA, Jeffrey T. Sprung , State of Washington, Attorney General's Office Complex Litigation Division, Seattle, WA, for Intervenor Defendant-Appellant State of Washington.

Samuel Siegel , Sacramento, CA, Scott H. Ikeda , Minnesota Attorney General's Office, Saint Paul, MN, for Saint Paul, MN, State of Minnesota.

August E. Flentje , U.S. Department of Justice Civil Division, Appellate Section, Washington, DC, Martin Vincent Totaro , U.S. Department of Justice, Washington, DC, for Defendants-Appellants United States of America, United States Department of Health and Human Services, Alex M. Azar, II, Secretary, U.S. Department of Health and Human Services, United States Internal Revenue Service, Charles P. Rettig, in his Official Capacity as Commissioner of Internal Revenue.

Douglas Neal Letter, Esq. , Brooks M. Hanner , Kristin Ann Shapiro, Assistant General Counsels, Todd Barry Tatelman , Deputy General Counsel, U.S. House of Representatives, Office of General Counsel, Washington, DC, Ginger Anders , Elaine Goldenberg , Jeremy Kreisberg , Jonathan Meltzer , Rachel Miller-Ziegler , Donald B. Verrilli, Jr. , Munger, Tolles & Olson, L.L.P., Washington, DC, Brian Rene Frazelle , Brian Rene Frazelle , Ashwin Pradyumna Phatak , Elizabeth Bonnie Wydra , Chief Counsel, Constitutional Accountability Center, Washington, DC, for Intervenor United States House of Representatives.

Eric Olson , Office of the Attorney General, Denver, CO, for Intervenor State of Colorado.

Nathanael Blake , Office of the Iowa Attorney General, Department of Justice, Des Moines, IA, Eric Olson , Office of the Attorney General, Denver, CO, for Intervenor State of Iowa.

Eric Olson , Office of the Attorney General, Denver, CO, Fadwa A. Hammoud , Michigan Department of Attorney General, Solicitor General Division, Lansing, MI, for Intervenor State of Michigan.

Eric Olson , Office of the Attorney General, Denver, CO, Heidi Parry Stern , Office of the Attorney General for the State of Nevada, Las Vegas, NV, for Intervenor State of Nevada.

Hyland Hunt , Deutsch Hunt, P.L.L.C., Washington, DC, for Amicus Curiae Small Business Majority Foundation.

John Allen Eidsmoe , Senior Counsel, Foundation for Moral Law, Montgomery, AL, for Amicus Curiae, Foundation for Moral Law.

Benjamin Michael Flowers , Office of the Attorney General for the State of Ohio, Columbus, OH, for Amici Curiae State of Ohio, State of Montana.

Jack R. Bierig, Esq. , Schiff Hardin, L.L.P., Chicago, IL, Catherine M. Masters , Faegre Baker Daniels, Chicago, IL, for Amici Curiae American Medical Association, American Academy of Allergy, Asthma and Immunology, American Academy of Family Physicians, American Academy of Pediatrics, American Association of Child and Adolescent Psychiatry, American Association of Public Health Physicians, American College of Correctional Physicians, American College of Obstetricians and Gynecologists, American College of Physicians, American College of Radiation Oncology, American Geriatrics Society, American Medical Women's Association, American Osteopathic Association, American Psychiatric Association, American Society of Hematology, American Society for Metabolic and Bariatric Surgery, GLMA Health Professionals Advancing LGBT Equality, Renal Physicians Association.

Joseph R. Palmore , Morrison & Foerster, L.L.P., Washington, DC, Joshua L. Hedrick , Hedrick Kring, P.L.L.C., Dallas, TX, for Amici Curiae Jonathan H. Adler, Nicholas Bagley, Abbe R. Gluck, Ilya Somin.

Sean Michael Marotta , Hogan Lovells US, L.L.P., Washington, DC, for Amici Curiae American Hospital Association, Federation of American Hospitals, Catholic Health Association of the United States, America's Essential Hospitals, Association of American Medical Colleges.

Pratik A. Shah , Z.W. Julius Chen , Akin Gump Strauss Hauer & Feld, L.L.P., Washington, DC, for Amicus Curiae America's Health Insurance Plans.

William B. Schultz , Nicholas M. DiCarlo , Zuckerman Spaeder, L.L.P., Washington, DC, for Amicus Curiae 24 State Hospitals Associations.

Beth Bivans Petronio, Esq. , Trial Attorney, K & L Gates, L.L.P., Dallas, TX, for Amici Curiae American Cancer Society, American Cancer Society Cancer Action Network, American Diabetes Association, American Heart Association, American Lung Association, Crohn's And Colitis Foundation, Cystic Fibrosis Foundation, Epilepsy Foundation, Global Healthy Living Foundation, Hemophilia Federation of America, Leukemia and Lymphoma Society, March of Dimes, National Alliance on Mental Illness, National Coalition for Cancer Survivorship, National Hemophilia Foundation, National Multiple Sclerosis Society, Kennedy Forum.

Stuart F. Delery , Gibson, Dunn & Crutcher, L.L.P., Washington, DC, for Amici Curiae First Focus, Children's Partnership.

A. Xavier Baker , Daniel W. Wolff , Crowell & Moring, L.L.P., Washington, DC for Amici Curiae Alliance Of Community Health Plans, Association For Community Affiliated Plans.

Benna Ruth Solomon , City of Chicago Law Department, Appeals Division, Chicago, IL, Lorraine Alofa Van Kirk, Office of the County Counsel, for the County of Santa Clara, San Jose, for Amici Curiae 35 Counties, Cities, and Towns, California State Association of Counties.

Maame Gyamfi , AARP Foundation Litigation, Washington, DC, for Amici Curiae American Association of Retired Persons, American Association of Retired Persons Foundation, Center for Medicare Advocacy, Justice in Aging.

John T. Kitchens, Esq. , Whitfield Law Group, P.L.L.C., Flowood, MS, for Amicus Curaie 483 Federally Recognized Tribal Nations.

Richard Salgado, Esq. , Dentons US, L.L.P., Dallas, TX, Peter J. Anthony , Dentons US, L.L.P., Washington, DC, Wade Carr , Dentons US, L.L.P., Kansas City for Amici Curiae AMERICAN Association of People with Disabilities, American Civil Liberties Union, Judge David L Bazelon Center for Mental Health Law, Disability Rights Education and Defense Fund, Eleven other Leading National Disability Rights Organizations.

Matthew S. Hellman , Jenner & Block, L.L.P., Washington, DC, for Amicus Curiae Bipartisan Economic Scholars.

Jaime Santos , Goodwin Procter, L.L.P., Washington, DC, for Amici Curiae Bipartisan Economic Scholars, National Partnership for Women and Families, Black Women's Health Imperative, American Medical Women's Association.

David Meir Zionts , Paige Jennings , Covington & Burling, L.L.P., Washington, DC, for Amicus Curiae HCA Healthcare, Incorporated.

Raffi Melkonian , Wright, Close & Barger, L.L.P., Houston, TC, for Amici Curiae Samuel L. Bray, Michael W. McConnell, Kevin C. Walsh.

Kenneth Lee Blalack, II , O'Melveny & Myers, L.L.P., Washington, DC, for Amicus Curiae Blue Cross Blue Shield Association.

Caitlin Joan Halligan , Ryan Wolfe Allison , Jessica Elaine Underwood , Selendy & Gay, P.L.L.C., New York, NY, for Amici Curiae Walter Dellinger, Douglas Laycock.

William B. Schultz , Margaret Dotzel , Zuckerman Spaeder, L.L.P., Washington, DC, for Amici Curiae Families USA, Community Catalyst, National Health Law Program, Center on Budget and Policy Priorities, Service Employees International Union.

Andrew Layton Schlafly , Far Hills, NJ, for Amicus Curiae Association of American Physicians & Surgeons and Citizens' Council for Health Freedom.

William Jeffrey Olson, Esq. , Vienna, VA, for Amici Curiae Citizens United, Citizens United Foundation, Gun Owners Foundation, Conservative Legal Defense and Education Fund, Eberle Communications Group, Incorporated, 60 Plus Association, 60 Plus Foundation, Fitzgerald Griffin Foundation, Downsize DC Foundation, Downsize DC.org, American Business Defense Foundation, Restoring Liberty Action Committee.

Jay A. Sekulow, Esq. , American Center for Law & Justice, Washington, DC, for Amicus Curiae American Center for Law and Justice.

Before KING, ELROD, and ENGELHARDT, Circuit Judges.


The Patient Protection and Affordable Care Act (the Act or ACA) is a monumental piece of healthcare legislation that regulates a huge swath of the nation's economy and affects the healthcare decisions of millions of Americans. The law has been a focal point of our country...

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