Brittany R. Tovar Plaintiff- Appellant
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 Amid on Behalf of Appellant (s)
Submitted: March 7, 2017
from United States District Court for the District of
Minnesota - Minneapolis
BENTON, BEAM, and MURPHY, Circuit Judges.
MURPHY, Circuit Judge.
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
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).
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.
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. failed for lack
of Article III standing. Tovar appeals.
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., 134
S.Ct. 1377, 1386-87 & n.4 (2014) (quoting Lujan v.
Defs. of Wildlife, 504 U.S. 555, 560 (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).
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 (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
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 ...