Scott v. St. Louis Univ. Hosp.

600 F.Supp.3d 956

Angelia SCOTT, Plaintiff,

v.ST. LOUIS UNIVERSITY HOSPITAL, Defendant.

Case No. 4:21-cv-01270-AGF

United States District Court, E.D. Missouri, Eastern Division.

Signed April 25, 2022

Mary Madeline Johnson, Law Office of Madeline Johnson, Platte City, MO, for Plaintiff.

Amy L. Blaisdell, Lauren A. Daming, Greensfelder Hemker PC, St. Louis, MO, for Defendant.

MEMORANDUM AND ORDER

AUDREY G. FLEISSIG, UNITED STATES DISTRICT JUDGE

This matter is before the Court on Defendant St. Louis University Hospital's Motion to Dismiss (Doc. No. 15) Plaintiff Angelia Scott's complaint. (Doc. No. 1-1). Plaintiff alleges Defendant violated Title VII of the Civil Rights Act (Count I) and the Patient Protection and Affordable Care Act (Count II) when it declined to provide health insurance coverage benefits that cover the cost of treatment for her son's gender dysphoria. For the reasons set forth below, the Court will grant in part and deny in part the motion.

BACKGROUND

Taken as true for the purpose of this motion, Plaintiff alleges the following facts. Plaintiff was an employee of Defendant. As a part of her employee compensation, Defendant provides Plaintiff and her dependents with health insurance coverage benefits through a privately funded plan administered by Cigna Healthcare. Plaintiff's benefits plan (the "Plan") includes a categorical exclusion of all care related to gender dysphoria and gender reassignment. Plaintiff's son is transgender and was diagnosed with gender dysphoria. Plaintiff sought treatment for her son's gender dysphoria but was denied coverage for the gender confirming health care due to the Plan's categorical exclusion. Plaintiff's son was forced to forgo or delay the gender confirming procedures, and Plaintiff incurred financial hardship, including out-of-pocket damages. (Doc. No. 1-1 at ¶ 63).

Based on these allegations, Plaintiff filed a charge of Discrimination with the Equal Employment Opportunity Commission (EEOC) on July 28, 2020. Plaintiff subsequently obtained a Notice of Right to Sue from the EEOC on June 30, 2021. On October 22, 2021, Plaintiff filed her complaint in the Circuit Court of the City of St. Louis, Missouri raising one claim under Title VII of the Civil Rights Act (Count I) and one claim under the Patient Protection and Affordable Care Act ("ACA") (Count II). Defendant subsequently removed the matter to this Court and filed its motion to dismiss. Defendant argues the complaint should be dismissed because Plaintiff's claims are both preempted by ERISA or, in the alternative, because Plaintiff does not fall within the class of plaintiffs who Congress authorized to sue pursuant to Title VII or the ACA. Plaintiff responded in opposition. The motion is fully briefed and ready for disposition.

DISCUSSION

"To survive a 12(b)(6) 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.’ " McShane Constr. Co. v. Gotham Ins. Co. , 867 F.3d 923, 927 (8th Cir. 2017) (quoting Ashcroft v. Iqbal , 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009) ). The purpose of a motion to dismiss is to test the legal sufficiency of the complaint. The factual allegations of a complaint are assumed true and construed in favor of the plaintiff, "even if it strikes a savvy judge that actual proof of those facts is improbable." Bell Atlantic Corp. v. Twombly , 550 U.S. 544, 556, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007) (citing Swierkiewicz v. Sorema N.A. , 534 U.S. 506, 508, 122 S.Ct. 992, 152 L.Ed.2d 1 (2002) ). But "[c]ourts are not bound to accept as true a legal conclusion couched as a factual allegation, and factual allegations must be enough to raise a right to relief above the speculative level." Torti v. Hoag , 868 F.3d 666, 671 (8th Cir. 2017).

I. ERISA Preemption

Defendant first argues Plaintiff's complaint must be dismissed because her plan is governed by ERISA, and as such ERISA is the exclusive remedy to enforce her rights. ERISA is a "comprehensive statute designed to promote the interests of employees and their beneficiaries in employee benefit plans." Shaw v. Delta Air Lines, Inc. , 463 U.S. 85, 90, 103 S.Ct. 2890, 77 L.Ed.2d 490 (1983). "The purpose of ERISA is to provide a uniform regulatory regime over employee benefit plans. To this end, ERISA includes expansive pre-emption provisions, see ERISA § 514, 29 U.S.C. § 1144, which are intended to ensure that employee benefit plan regulation would be ‘exclusively a federal concern.’ " Aetna Health Inc. v. Davila , 542 U.S. 200, 208, 124 S.Ct. 2488, 159 L.Ed.2d 312 (2004) (quoted case omitted). Section 1144 expressly preempts state laws related to employee benefit plans:

Except as provided in subsection (b) of this section, the provisions of this subchapter and subchapter III shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan described in section 1003(a) of this title and not exempt under section 1003(b) of this title.

29 U.S.C. § 1144(a).

Defendant claims that ERISA likewise preempts Plaintiff's federal law claims. However, ERISA expressly excludes federal laws from its preemption provisions: "[n]othing in this subchapter shall be construed to alter, amend, modify, invalidate, impair, or supersede any law of the United States (except as provided in sections 1031 and 1137(b) of this title) or any rule or regulation issued under any such law."¹ 29 U.S.C. § 1144(d). See also Doe v. CVS Pharmacy, Inc. , 982 F.3d 1204, 1210 (9th Cir. 2020), cert. granted in part , ––– U.S. ––––, 141 S. Ct. 2882, 210 L.Ed.2d 990 (2021), and cert. dismissed sub nom. CVS Pharmacy, Inc. v. Doe, One , ––– U.S. ––––, 142 S. Ct. 480, ––– L.Ed.2d –––– (2021) (allowing plaintiff to assert a claim of sex discrimination in violation of § 1557 of the ACA for discriminatory benefits provided by a group health plan governed by ERISA).

Defendant relies on Slice v. Sons of Norway to support its proposition that ERISA is Plaintiff's exclusive remedy. 34 F.3d 630, 631-32 (8th Cir. 1994). Slice, a retiree, brought a claim under ERISA after his monthly pension benefits were decreased, alleging he was entitled to relief pursuant to two sections of ERISA: 29 U.S.C. § 1132(a)(3)(B) and 29 U.S.C. § 1104(a). Slice also alleged a claim for equitable estoppel under federal law. The Eighth Circuit determined Slice had not stated a claim pursuant to ERISA, noting "ERISA's civil enforcement provisions, set forth in 29 U.S.C. § 1132(a), provide the exclusive remedy for participants or beneficiaries seeking to enforce their rights under an ERISA plan." Id. at 631–32. Defendant claims that, pursuant to Slice , Plaintiff's claims under Title VII and the ACA must be dismissed because ERISA's civil enforcement provisions are Plaintiff's exclusive remedy.

Defendant misinterprets Slice . Slice dismissed the plaintiff's ERISA claims, finding ERISA's civil enforcement provisions are the exclusive remedy to enforce rights pursuant to that statute. The Eighth Circuit did not hold that ERISA preempted Slice's federal equitable estoppel claim; instead, the court found Slice had failed to state a claim. Slice, 34 F.3d at 635. Here, Plaintiff has not alleged a claim pursuant to ERISA, and is not "seeking to enforce [her] rights under an ERISA plan." Id. Instead, Plaintiff admits the Plan expressly excludes coverage for sex transition and she has no rights to enforce under the Plan. (Doc. No. 19 at 4). ERISA does not preempt other federal law claims, including Plaintiff's claims pursuant to Title VII and the ACA. See CVS Pharmacy, Inc. , 982 F.3d at 1210.

II. Title VII

Defendant next argues Plaintiff's Title VII claim should be dismissed because Plaintiff is not authorized to sue under Title VII. Defendant claims Plaintiff has not alleged that it discriminated against her on the basis of her sex—only that it discriminated on the basis of her son's sex. As such, Defendant argues Plaintiff is not within the zone of interests protected by Title VII.

"[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." Thole v. U.S. Bank Nat'l Ass'n , 873 F.3d 617, 628 (8th Cir. 2017) (second alteration in original) (quoting Tovar v. Essentia Health , 857 F.3d 771, 774 (8th Cir. 2017) (" Tovar I ")). This requirement, sometimes inaptly referred to as "prudential standing," arises, in part, from "the general prohibition on a litigant's raising another person's legal rights ... and the requirement that a plaintiff's complaint fall within the zone of interest protected by the law invoked." Lexmark Int'l, Inc. v. Static Control Components, Inc. , 572 U.S. 118, 126, 134 S.Ct. 1377, 188 L.Ed.2d 392 (2014) (quoting Elk Grove Unified Sch. Dist. v. Newdow , 542 U.S. 1, 12, 124 S.Ct. 2301, 159 L.Ed.2d 98 (2004) ). An assessment of the "zone of interests" to which a given statute is directed may involve reference to "statement[s] of the statute's purposes." See id. at 131, 134 S.Ct. 1377 (reviewing statute's statement of purposes in resolving zone-of-interests issue). If a plaintiff does not fall within the class of those authorized to sue, the cause of action may be subject to dismissal pursuant to Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim.

Title VII makes it unlawful for employers "to discriminate against any individual with respect to his compensation, terms, conditions, or privileges of employment because of such individual's race, color, religion, sex or national origin...." 42 U.S.C. § 2002e-2(a). "Health insurance and other fringe benefits are ‘compensation, terms, conditions, or privileges of employment.’ " Newport News Shipbuilding & Dry Dock Co. v. E.E.O.C. , 462 U.S. 669, 682–83, 103 S.Ct. 2622, 77 L.Ed.2d 89 (1983) (quoting 42 U.S.C. § 2002e-2(a)). Defendant argues Plaintiff has not stated a claim pursuant to Title VII because she...