Opinion handed down April 10, 2015
Following the passing of the controversial Patient Protection and Affordable Care Act (“ACA”), the Missouri legislature passed the Health Insurance Marketplace Innovation Act (“HIMIA”), seeking to regulate certain aspects of health care exchanges within the state of Missouri.[1] Acting under the authority of the ACA, the United States Department of Health and Human Services (“HHS”) promulgated regulations that conflicted with the Missouri laws pertaining to healthcare marked facilitators.[2] The petitioners, a group of healthcare-related organizations and businesses, challenged the HIMIA, seeking a preliminary injunction enjoining the enforcement of the HIMIA that were contrary to federal law.[3] The district court granted the preliminary injunction and enjoined the HIMIA from being enforced in its entirety.[4]
The U.S. Court of Appeals for the Eighth Circuit affirmed in part and vacated in part, holding: (1) the petitioners were likely to succeed on their claims that three specific provisions of the HIMIA were preempted by federal regulation; and (2) the preempted specific provisions of the HIMIA were severable from the remainder of the Missouri law, resulting in a preliminary injunction only enjoining the State from enforcing the three challenged provisions, leaving the remainder of the HIMIA in effect.[5]